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Waldrop C, Showstark M. Exploring Extended Reality in Physician Assistant/Associate Educational Training Programs: A State-of-the-Art (Technology) Review. J Physician Assist Educ 2025; 36:e213-e217. [PMID: 40164989 DOI: 10.1097/jpa.0000000000000669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2025]
Abstract
INTRODUCTION As the world becomes more technology focused, emerging technologies such as extended reality (XR) have been incorporated into medical education over the past few decades. Now that XR is more accessible to physician assistant (PA) education, educators must determine the extent to which XR can improve knowledge retention over current modalities. The purpose of this article was to perform a review of what XR pedagogical approaches are being used in PA education and what value they provide to learning. METHODS A thorough literature database search conducted by a research librarian identified 228 unique articles published between 2012 and August 2023. These articles were further categorized by date, language, study method, and population sample and further screened for relevance and eligibility. Of the 228 unique articles identified, 8 met the eligibility criteria for this review. RESULTS The focus of research ranged from XR integration to proof of concept of XR in educational environments. Selected studies used both qualitative and quantitative data. General impressions of XR in PA education reflect its potential to supplement current methods; however, the authors also admit the need for additional critical analysis. DISCUSSION While there is a paucity of research into this specific topic, multiple studies showed that using XR principles in medical education led to better confidence among students and improved their perception of learning. While there currently is no direct statistically significant evidence to show a superiority of XR over traditional didactic learning, it is important to consider that not all educational tools need to improve outcomes; rather, they can improve student perception, which opens the door to further learning. Future studies should continue to longitudinally evaluate integrating XR into PA programs with a specific focus on knowledge retention.
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Affiliation(s)
- Chelsea Waldrop
- Chelsea Waldrop, MS, MMSC, PA-C, Yale School of Medicine Physician Assistant Online Program, Poyner Mental Health Services
- Mary Showstark, MPAS, PA-C, is an assistant professor adjunct and affiliate faculty, Yale Institute of Global Health, New Haven, Connecticut
| | - Mary Showstark
- Chelsea Waldrop, MS, MMSC, PA-C, Yale School of Medicine Physician Assistant Online Program, Poyner Mental Health Services
- Mary Showstark, MPAS, PA-C, is an assistant professor adjunct and affiliate faculty, Yale Institute of Global Health, New Haven, Connecticut
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Romano D, Lynch S, Komor T, Rhodes-Keefe J, Collier R, Sprague LM. Exploring the Effect on Pharmacy Students' Empathy Following a Simulation Using 360-Degree Video. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2025; 89:101402. [PMID: 40185312 DOI: 10.1016/j.ajpe.2025.101402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2024] [Revised: 03/28/2025] [Accepted: 03/31/2025] [Indexed: 04/07/2025]
Abstract
OBJECTIVE To explore the effects of a simulation using virtual reality 360-degree video on the empathy of pharmacy students. METHODS First-year pharmacy students participated in a synchronous, in-person simulation using 360-degree video technology. The 4-min immersive video was developed from a patient perspective to improve the learner's understanding and increase empathy for the patient. Empathy was assessed using the Toronto Empathy Questionnaire (TEQ), which was administered presimulation and postsimulation, along with responses to an open-ended reflection question postsimulation. RESULTS Forty-four students participated in the simulation. A total of 12 students completed the TEQ before and after the simulation. There was no statistically significant change in TEQ scores pre and postsimulation. Researchers analyzed the written takeaway responses of all 44 students who participated in the simulation. Qualitative analysis revealed the following themes: silent struggle, patient-centered focus, safe environment, and communication. CONCLUSION Despite the lack of significant change in TEQ scores, the qualitative findings from this pilot study revealed 4 key themes. These themes highlighted that, upon reflecting on their participation in the 360-degree video simulation, students understood the key attributes of empathy and recognized the value of providing empathetic care to patients and communication that promotes empathetic care. Further research is required to determine if 360-degree video is an effective method of simulation delivery to enhance empathy in pharmacy students.
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Wang Q, Wang F, Jiang C, Guo J. The role of cardiac ultrasound virtual simulation technology in the construction of clinical diagnostic reasoning of structural heart diseases. BMC MEDICAL EDUCATION 2025; 25:634. [PMID: 40301832 PMCID: PMC12042301 DOI: 10.1186/s12909-025-07225-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2024] [Accepted: 04/24/2025] [Indexed: 05/01/2025]
Abstract
BACKGROUND Clinical reasoning education is a very systematic and highly logical medical learning process, but the existing teaching models and methods often divide this process into several stages for separate training using a virtual reality (VR)simulator can simulate and reconstruct the cardiac anatomical structure, ultrasonic section operation, and color doppler ultrasound parameter measurement, then integrate it into a single disease or case. In this case, the students' operation skills,decision-making and communication skills were trained by cardiac physical examination, inquiry and interpretation of laboratory examination results. This study aims to investigate whether the application of virtual simulation technology in cardiac ultrasound learning can improve students' thinking ability in the diagnosis and treatment of structural heart diseases. METHOD This study involved fifty-nine undergraduate students studying clinical medicine in the fifth semester at Jinan University. We employed a simple randomization method for random grouping. Random numbers were generated in Excel based on the students' student IDs. Then the students were sorted and divided into the experimental group, which used virtual simulation teaching based on ultrasound, and the control group, which used traditional teaching method. Following the completion of theory teaching, operation demonstration, clinical skills practice and VR practice, students underwent an offline image assessment and online systematic test, which included cardiac ultrasound operation assessment and virtual simulation case assessment to evaluate their proficiency in clinical skills and analytical ability in clinical reasoning. Furthermore, the VR group was given a separate questionnaire to provide their feedback on the cardiac ultrasound virtual simulation education. RESULTS There were no statistically significant differences between the two groups in the scores for offline image interpretation and patient inquiry in the virtual simulation case analysis (P > 0.05). The scores for physical examination in virtual simulation case analysis (P < 0.05), virtual simulation ultrasound manipulation(P < 0.05) and diagnosis in virtual simulation case analysis(P < 0.05) were higher in the VR group than in the control group, and the difference was statistically significant. The total score for all evaluation of teaching quality in the VR group was higher than in the control group (P < 0.05). Furthermore, the majorityof students in the VR group displayed satisfaction with course experience, learning effect, teaching evaluation, and overall evaluation. CONCLUSION This research demonstrates that cardiac ultrasound virtual simulation technology could improve students' thinking ability in diagnosing and treating of structural heart diseases. The virtual simulation technology not only could be used for technology imitation but also could leverage its characteristics to demonstrate the process of a certain disease from anatomy to pathophysiology and clinical signs from shallow to deep.
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Affiliation(s)
- Qianyun Wang
- Department of Cardiology, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Feifei Wang
- Department of Cardiology, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
| | - Can Jiang
- Department of Cardiology, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Jun Guo
- Department of Cardiology, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
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Huang KT, Ma Z, Yao L. Media-Induced and Psychological Factors That Foster Empathy Through Virtual Reality in Nursing Education: 2×2 Between-Subjects Experimental Study. JMIR MEDICAL EDUCATION 2025; 11:e59083. [PMID: 40163855 PMCID: PMC11975256 DOI: 10.2196/59083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 11/07/2024] [Accepted: 01/02/2025] [Indexed: 04/02/2025]
Abstract
Background Virtual reality (VR) has emerged as a promising tool in medical education, particularly for fostering critical skills such as empathy. However, how VR, combined with perspective-taking, influences affective empathy in nursing education remains underexplored. Objective This study investigates the influence of VR and perspective-taking on affective empathy in nursing education, focusing on 4 psychological factors: perceived self-location, narrative transportation, emotional engagement, and affective empathy. Methods A 2×2 between-subjects design was used, involving 69 nursing undergraduates from two Midwest universities. The participants engaged with a narrative-focused video game, That Dragon, Cancer, in either VR or non-VR conditions and from the perspective of either parents or clinicians. Results VR significantly enhanced perceived self-location (P=.01), while adopting a clinician's perspective amplified emotional engagement (P=.03). However, VR did not significantly influence narrative transportation (P=.35). An interaction effect was found between the platform and player's perspective on narrative transportation (P=.04). Several indirect effects of media elements on affective empathy were observed via other psychological factors, though the direct effect of VR on affective empathy was not significant (P=.84). Conclusions These findings underscore the potential of VR in medical education, suggesting that perspective-taking should be carefully considered when designing immersive learning experiences. The study advocates for broader integration of VR technologies into medical curricula to enhance instruction quality and patient-centered care.
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Affiliation(s)
- Kuo-Ting Huang
- Department of Information Culture and Data Stewardship, University of Pittsburgh, 135 N Bellefield Ave, Room 616, Pittsburgh, PA, 15213, United States, 1 4123839941
| | - Zexin Ma
- Department of Communication, University of Connecticut, Storrs, CT, United States
| | - Lan Yao
- School of Nursing, Oakland University, Rochester, MI, United States
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Tan CP, Howes DC, Manikam A, Lim SM. Role of a Dementia Virtual Reality App in Developing Situated Empathy, Attitude and Person-Centred Care-A Qualitative Approach. Int J Older People Nurs 2025; 20:e70012. [PMID: 39895420 DOI: 10.1111/opn.70012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 10/18/2024] [Accepted: 01/10/2025] [Indexed: 02/04/2025]
Abstract
BACKGROUND The demands of any health education programme including nurse education would benefit from innovative ways to support students learning in an effective and efficient manner. Such approaches resonate particularly when caring for older people living with dementia, due to multifactorial manifestations of the condition, patients' difficulty in articulating their needs and the potential for negative care outcomes. Empathy is an important part of understanding dementia and is also recognised as a complex and multidimensional concept. OBJECTIVE This study investigated the impact of undergraduate nursing students' 15-min use of the Experience Dementia in Singapore (EDIS) virtual reality app in their tutorial lesson for developing their empathy, changing their attitude and increasing their sensitivity for person-centred care of people with dementia. METHOD We carried out content and thematic analysis of data anonymously collected via the in-class learning activities at the start and at the end of the lesson. RESULTS All participating students (n = 89, 89% response rate) achieved their learning goal to experience a first-person perspective and gain insights into needs and care for persons living with dementia. The results showed students transitioned from having mainly knowledge foremost in their mind, to more empathetic and care related thoughts when delivering care to persons living with dementia. The experience made more students aware of how they could communicate care, make environmental modifications to support and develop an attitude of person-centred care for persons living with dementia and their families. The analysis resulted in four themes: (1) immersive learning-walking in the shoes of the person living with dementia (2) feelings evoked from the first-person perspective (3) little things, big impact; little things, positive impact; and (4) communicating care. CONCLUSION The EDIS virtual reality app was an efficient and effective way for students to develop essential elements, especially empathy, as well as positive attitudes and sensitivity towards person-centred care for those living with dementia. IMPLICATIONS FOR PRACTICE The first-hand experience the VR app offers allows students to challenge pre-conceived perceptions about older people and those living with dementia. As such, it is a versatile tool that can be incorporated into a variety of study and training programmes for students, professionals and caregivers who provide care or care solutions for persons living with dementia and their families.
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Affiliation(s)
- Chin Pei Tan
- SIT Teaching and Learning Academy, Singapore Institute of Technology, Singapore
| | - Dora C Howes
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | | | - Sok Mui Lim
- Office of the Provost and Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
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Koivisto JM, Kämäräinen S, Mattsson K, Jumisko-Pyykkö S, Ikonen R, Haavisto E. Exploring Nursing Students' Experiences of Empathy and User Experiences in an Immersive Virtual Reality Simulation Game: Cross-Sectional Study. JMIR Serious Games 2025; 13:e62688. [PMID: 39946691 PMCID: PMC11888114 DOI: 10.2196/62688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 11/06/2024] [Accepted: 12/16/2024] [Indexed: 03/10/2025] Open
Abstract
BACKGROUND Empathy is associated with better clinical outcomes and patient-care experiences, and it has been demonstrated that training can improve nursing students' empathy. The use of virtual reality (VR) as an experiential learning strategy may increase the empathetic behavior of caregivers. Although much research exists on the use of VR in education, there is still little research on learning empathy in nursing education through immersive VR games that include a head-mounted display and hand controllers. In addition, it is important to study both learning and user experiences in nursing education that utilizes VR technology. OBJECTIVE This study aims to explore nursing students' experiences of empathy and user experiences in an immersive VR simulation game. METHODS A cross-sectional design was used. A total of 52 graduating nursing students from 3 universities of applied sciences in Finland participated in the study. The immersive VR simulation game employed in the study was played with a head-mounted display and hand controllers. The instruments used were the Basic Empathy Scale in Adults (BES-A) before the VR simulation gaming session and the Comprehensive State Empathy Scale (CSES) and AttrakDiff 2.0 Scale after the session. RESULTS The students' overall level of empathy experienced in the immersive VR simulation game was favorable (CSES; mean 2.9, SD 0.57). Participants who had a higher level of empathy (BES-A) before playing the immersive VR simulation game also experienced slightly more feelings of empathy after playing (CSES). However, the association between the measures was not statistically significant (r=0.187, P=.18). The overall empathy (CSES) experienced in the immersive VR simulation game was positively correlated with its subscales. The use of the VR simulation provided a positive user experience in all 4 factors of the AttrakDiff 2.0 Scale. Overall User Experience and Emotion Sharing correlated negatively (r=-0.248, P=.042), as did Attractiveness and Emotion Sharing (r=-0.327, P=.018). Hedonic Quality Stimulation correlated negatively with Cognitive Empathy (r=-0.279, P=.045). CONCLUSIONS The results of this study indicate that the use of an immersive VR simulation game in nursing education as a means of increasing empathy seems promising and justified. The immersive VR simulation game offered positive user experiences, which further supported the idea of implementing it in education. However, more research is needed on what kinds of VR environments are the most effective in promoting empathy among nursing students. Furthermore, when using VR technology in learning, one should consider that the VR setting must not be too technical but rather simple, straightforward, and predictable.
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Affiliation(s)
- Jaana-Maija Koivisto
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Health Sciences/Nursing Science, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Sanna Kämäräinen
- Department of Health Sciences/Nursing Science, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Katri Mattsson
- Department of Health and Well-Being, Turku University of Applied Sciences, Turku, Finland
| | - Satu Jumisko-Pyykkö
- Department of HAMK Tech, Häme University of Applied Sciences, Hämeenlinna, Finland
| | - Riikka Ikonen
- Department of Health Sciences/Nursing Science, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Elina Haavisto
- Department of Health Sciences/Nursing Science, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Tampere University Hospital, Tampere, Finland
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Pira GL, Ruini C, Vescovelli F, Baños R, Ventura S. Could Empathy Be Taught? The Role of Advanced Technologies to Foster Empathy in Medical Students and Healthcare Professionals: A Systematic Review. J Med Syst 2025; 49:6. [PMID: 39806022 PMCID: PMC11729101 DOI: 10.1007/s10916-025-02144-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Accepted: 01/07/2025] [Indexed: 01/16/2025]
Abstract
The physician-patient relationship relies mostly on doctors' empathetic abilities to understand and manage patients' emotions, enhancing patient satisfaction and treatment adherence. With the advent of digital technologies in education, innovative empathy training methods such as virtual reality, simulation training systems, mobile apps, and wearable devices, have emerged for teaching empathy. However, there is a gap in the literature regarding the efficacy of these technologies in teaching empathy, the most effective types, and the primary beneficiaries -students or advanced healthcare professionals-. This study aims to address this gap through a literature review following PRISMA guidelines. A comprehensive literature search was conducted in the PsychINFO, Scopus, PubMed, and Web of Science databases using specific keywords. Inclusion criteria for articles were established, and two researchers independently rated the selected articles, resolving any disagreements by consensus. Out of 1137 articles screened, a total of 14 articles were included in this review with a total of 1285 participants, who received empathic training integrated with the use of digital technologies. Only 9 articles defined the construct of empathy, focusing on cognitive, affective, clinical, or cultural aspects. Empathy was assessed with various methods and promoted through various digital technologies, including wearables (e.g. HMDs, SymPulse™ armband) and non-wearable devices (computer monitors, Mobile Apps, Kinect System). Participants were primarily medical students (68.1%), with few healthcare workers (31.9%) and nurses (2.9%). All digital technologies effectively promoted empathy among the target population except for 3 studies that involved advanced career healthcare workers. This review highlights the potential efficacy of digital technologies in fostering empathy among medical students, though not as effectively among advanced healthcare professionals. These insights have implications for designing targeted educational programs that address the distinct needs of healthcare professionals at varying career stages. Limitations and future research directions are also discussed.
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Affiliation(s)
- Giorgio Li Pira
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Chiara Ruini
- Department for Life Quality Studies, University of Bologna, Rimini, Italy.
| | | | - Rosa Baños
- Instituto Polibienestar, University of Valencia, Valencia, Spain
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Madrid, Spain
| | - Sara Ventura
- Instituto Polibienestar, University of Valencia, Valencia, Spain
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Clay CJ, Hochmuth JM, Wirth O. Virtual Reality Training to Reduce Workplace Violence in Healthcare. Issues Ment Health Nurs 2025; 46:2-11. [PMID: 39761223 PMCID: PMC11774209 DOI: 10.1080/01612840.2024.2429712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2025]
Abstract
Violence against nurses and other healthcare workers is a significant and escalating concern, impeding the provision of safe and effective healthcare services. A majority of nurses experience some kind of violence, including physical and nonphysical assaults during their careers. The consequences of workplace violence extend beyond individual trauma, leading to increased burnout, turnover, and significant financial costs for healthcare systems. Training programs focused on workplace violence prevention (WVP) have become ubiquitous, with elements like situational threat assessment, de-escalation techniques, and physical skills. Studies show that experiential components, such as role play, enhance the effectiveness of these trainings. Virtual Reality (VR) offers a promising solution by providing immersive, interactive training environments that enhance decision-making, physical coordination, and team dynamics. In this article we discuss how VR simulations can replicate real-world settings, allowing healthcare workers to practice and master violence prevention and management skills in a controlled, safe environment. We also describe how VR is scalable and cost-effective, enabling widespread adoption within and across organizations with minimal logistical challenges. Integrating VR into WVP training programs could significantly improve training outcomes, reduce the need for physical and chemical restraints, and ultimately enhance the overall safety and quality of healthcare services.
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Affiliation(s)
- Casey J. Clay
- Department of Special Education and Rehabilitation Counseling, Utah State University, Logan, Utah, USA
| | - Jonathan M. Hochmuth
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Oliver Wirth
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
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Birkheim SL, Calogiuri G, Hvalstad M, Martinsen R. Exploring the experiences of resident doctors in child and adolescent psychiatry with virtual reality-based simulation training: a qualitative study. BMC Health Serv Res 2024; 24:1443. [PMID: 39567929 PMCID: PMC11580656 DOI: 10.1186/s12913-024-11941-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2024] [Accepted: 11/14/2024] [Indexed: 11/22/2024] Open
Abstract
BACKGROUND The use of virtual reality simulation for the training of non-technical skills among healthcare professionals may improve professional development as well as the quality of care. This study aims to explore the experiences of resident doctors in child and adolescent psychiatry with the use of virtual reality-based simulation for the training of non-technical skills. METHODS The study had an exploratory qualitative design. Data were collected through observations of thirteen resident doctors in child and adolescent psychiatry during their participation in three virtual reality-based simulation sessions, followed by two focus groups. Data were analyzed using reflective thematic analysis. RESULTS The analysis revealed the following three themes: 1) The importance of pedagogical principles, 2) Playful and motionally affected learning, and 3) Observational learning contributing to lifelong learning. CONCLUSIONS Virtual reality-based simulation was felt to be an appropriate method of training non-technical skills for resident doctors in child and adolescent psychiatry. In particular, the intervention met resident doctors' desires and needs regarding learning through observation and peer discussions. However, some challenges related to technical issues and the content of the scenarios were highlighted. This method may not only increase the resident doctors' self-efficacy and competence, but also contribute to their lifelong learning.
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Affiliation(s)
- Siv Lena Birkheim
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, P.B. 400, 2418, Elverum, Norway.
- Innlandet Hospital Trust, P.B 104, 2380, Brumunddal, Norway.
| | | | - Mette Hvalstad
- Innlandet Hospital Trust, P.B 104, 2380, Brumunddal, Norway
| | - Randi Martinsen
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, P.B. 400, 2418, Elverum, Norway
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Lin HL, Wang YC, Huang ML, Yu NW, Tang I, Hsu YC, Huang YS. Can virtual reality technology be used for empathy education in medical students: a randomized case-control study. BMC MEDICAL EDUCATION 2024; 24:1254. [PMID: 39497110 PMCID: PMC11536554 DOI: 10.1186/s12909-024-06009-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Accepted: 09/10/2024] [Indexed: 11/06/2024]
Abstract
BACKGROUND Empathy is an important factor in the doctor-patient relationship, but mental illness is more difficult to understand than other diseases. Besides traditional skills, virtual reality (VR) has been identified as a promising tool in empathy education. This study aimed to investigate the ability of empathy enhancement, the feasibility of depression education, and the changes in thoughts and attitudes in medical students through a single VR experience. METHODS We recruited medical students and randomly assigned them to two groups based on their completed Interpersonal Response Index scores. Two sets of VR systems were provided; the intervention group experienced the daily life of the depressed medical student, while the control group experienced the general medical student scenario. The improvement of empathy was assessed using the Jefferson Scale of Empathy-Health Professional Students (JSE-HPS), and the change of attitude was assessed through the Implicit Association Test. In addition, other questionnaires were used to evaluate the user experience of this VR system, and correlation analysis was conducted to examine the association between the use of VR and changes in the JSE and IAT scores. RESULTS A total of 59 medical students were enrolled in this study. The intervention group showed a significant increase in the perspective-taking (pre: mean 5.817, SD 0.536; post: mean 5.947, SD 0.620; P = .03) and compassionate care (pre: mean 5.546, SD 0.581; post: mean 5.721, SD 0.629; P = .01) domains of the JSE score and a significant decrease in the standing in the patient's shoes (SP) domain (pre: mean 3.583, SD 1.253; post: mean 2.967, SD 1.252; P = .002). The Pearson correlation analysis found a significant positive correlation between the JSE score with immersion aspect (r = .308, P = .049) and presence aspect (r = .415, P = .01), and we also found a significant negative correlation between the IAT score and presence aspect (r=-.333, P = .04). CONCLUSIONS This study is the first randomized case-control study to investigate the effect of two different versions of VR on empathy development toward depression for medical students. Although the single VR experience was unable to induce a great improvement in empathy or attitude, the VR system could help medical students enhance their understanding of depressive disorders. TRIAL REGISTRATION This trial was retrospectively registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) (21/03/2024, ACTRN12624000297527). https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=386683&isReview=true .
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Affiliation(s)
- Huang-Li Lin
- Department of Psychiatry, Chang-Gung Memorial Hospital, Linkou, 5, Fu-Shing St., Kwei-Shan, Taoyuan, 333, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu-Ching Wang
- Department of Psychiatry, Chang-Gung Memorial Hospital, Linkou, 5, Fu-Shing St., Kwei-Shan, Taoyuan, 333, Taiwan
| | - Man-Lin Huang
- Institute of Information Systems and Applications, National Tsing Hua University, Hsinchu, Taiwan
| | - Nan-Wen Yu
- Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - I Tang
- Department of Psychiatry, Chang-Gung Memorial Hospital, Linkou, 5, Fu-Shing St., Kwei-Shan, Taoyuan, 333, Taiwan
| | - Yu-Chen Hsu
- Institute of Learning Sciences and Technologies, National Tsing Hua University, Hsinchu, Taiwan.
| | - Yu-Shu Huang
- Department of Psychiatry, Chang-Gung Memorial Hospital, Linkou, 5, Fu-Shing St., Kwei-Shan, Taoyuan, 333, Taiwan.
- Chang Gung University College of Medicine, Taoyuan, Taiwan.
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Caruso TJ, Rama A, Uribe-Marquez S, Mitchell JD. Pro-Con Debate: Virtual Reality Compared to Augmented Reality for Medical Simulation. Anesth Analg 2024:00000539-990000000-00997. [PMID: 39424614 DOI: 10.1213/ane.0000000000007057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2024]
Affiliation(s)
- Thomas J Caruso
- From the Division of Pediatric Anesthesiology, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine,Stanford, California
| | - Asheen Rama
- From the Division of Pediatric Anesthesiology, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine,Stanford, California
| | - Santiago Uribe-Marquez
- Department of Anesthesiology, Pain Management, and Perioperative Medicine, Henry Ford Health, Detroit, Michigan
| | - John D Mitchell
- Department of Anesthesiology, Pain Management, and Perioperative Medicine, Henry Ford Health, Detroit, Michigan
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Hudise JY, Mojiri ME, Shawish AM, Majrashi KA, Ayoub AY, Alshammakhi AM, Akoor FA, Madkhali KA, Fathi MA, Areeshi RA, Hakami AJ, Almudawi AM, Al-Mosaeed AS, Akkam MM, Sharahili RM. The Role of Virtual Reality in Advancing Surgical Training in Otolaryngology: A Systematic Review. Cureus 2024; 16:e71222. [PMID: 39525093 PMCID: PMC11549949 DOI: 10.7759/cureus.71222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2024] [Indexed: 11/16/2024] Open
Abstract
Technological advancements have rapidly transformed medical education and surgical training, with virtual reality (VR) emerging as a valuable tool. VR offers immersive and interactive environments, enhancing the development of surgical skills without the risks that come with conventional training methods. In this review, we conducted a comprehensive search across PubMed, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL), considering all relevant publications up to June 30, 2024. This review focused on randomized controlled trials involving medical students, where VR was used alone or in combination with other educational approaches, compared to traditional training methods. Two independent reviewers extracted data and assessed the quality of studies using the modified Downs and Black scale. Of 1,074 identified articles, six studies met the inclusion criteria. These studies, conducted in Denmark and Australia, utilized a range of VR platforms, including the Visible Ear Simulator, MediseusVR Surgical Drilling Simulator, and Geomagic Haptic device. Quality assessments showed that the studies generally had strong methodology, with reporting scores between 7 and 8 out of 11, and external validity scores between 2 and 3 out of 3. Results indicated that VR training has the potential to improve hand-eye coordination, spatial awareness, and surgical performance in ENT procedures. However, findings on VR's superiority over traditional methods were mixed, as some studies found no substantial differences in performance metrics. Overall, VR offers a controlled and risk-free training environment that may enhance the acquisition and retention of surgical skills in ENT surgery. Although VR demonstrates significant promise, additional research is needed to fully establish its effectiveness and explore its broader application in surgical education. This systematic review provides a detailed evaluation of VR's impact on ENT surgical training, highlighting its potential to transform the future of surgical education.
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Affiliation(s)
- Jibril Y Hudise
- Otolaryngology, King Faisal Medical City for Southern Region, Abha, SAU
| | | | | | | | | | | | | | | | - Maha A Fathi
- College of Medicine, Jazan University, Jazan, SAU
| | | | - Ali J Hakami
- College of Medicine, Jazan University, Jazan, SAU
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Sari DW, Kugai H, Igarashi A, Takaoka M, Matsumoto H, Suzuki H, Wu J, Fitryasari R, Nasifah IA, Has EMM, Yamamoto-Mitani N. Education Program for Enhancing Health Care Students' Attitudes Toward People Living With Dementia: Protocol for a Single-Arm Pre-Post Study. JMIR Res Protoc 2024; 13:e62654. [PMID: 39293050 PMCID: PMC11447417 DOI: 10.2196/62654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/18/2024] [Accepted: 07/24/2024] [Indexed: 09/20/2024] Open
Abstract
BACKGROUND Health care students are instrumental in shaping the future of dementia care. Cultivating a positive attitude and understanding toward people living with dementia is crucial for diminishing the stigma associated with the condition, providing effective and person-centered care, and enhancing the quality of life for people living with dementia. Educational programs about dementia are increasingly recognizing the potential of gaming tools. OBJECTIVE This study aimed to evaluate the effectiveness of gaming-based dementia educational programs in improving attitudes toward people living with dementia among health care students. METHODS This single-arm pre-post study will be conducted among health care students in Indonesian universities. This educational program based on gaming tools will consist of a lecture on dementia, the use of N-impro (gaming tool), and the enactment of short dramas depicting desirable and undesirable communication with people living with dementia behaviors. We will assess attitudes toward people living with dementia, intention to help people living with dementia, knowledge of dementia, and the stigma associated with people living with dementia. The gaming-based dementia education program will be integrated into the curriculum of the health care students. The program will be implemented once with a duration of 90 minutes. RESULTS Data collection will occur from August 2023 to March 2024. Analysis of the data will be finalized by May 2024, and the outcome will be determined by July 2024. The impact of the gaming-based dementia educational program on improving attitudes toward people living with dementia will be reported. The study findings will be published in a peer-reviewed journal. CONCLUSIONS The gaming education program demonstrates significant potential in enhancing attitudes toward people living with dementia across various countries, introducing an innovative method for the community-based support of people living with dementia. TRIAL REGISTRATION ClinicalTrials.gov NCT06122623; https://clinicaltrials.gov/study/NCT06122623. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/62654.
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Affiliation(s)
- Dianis Wulan Sari
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
- Dementia and Aging Care Research Centre, Universitas Airlangga, Surabaya, Indonesia
| | - Haruna Kugai
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
- Global Nursing Research Centre, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ayumi Igarashi
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
- Global Nursing Research Centre, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Manami Takaoka
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
- Global Nursing Research Centre, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroshige Matsumoto
- Global Nursing Research Centre, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Community Health Nursing, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Haruno Suzuki
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA, United States
| | - Jinyan Wu
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
| | - Rizki Fitryasari
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
- Dementia and Aging Care Research Centre, Universitas Airlangga, Surabaya, Indonesia
| | - Ike Ayunda Nasifah
- Dementia and Aging Care Research Centre, Universitas Airlangga, Surabaya, Indonesia
| | | | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
- Global Nursing Research Centre, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Asoodar M, Janesarvatan F, Yu H, de Jong N. Theoretical foundations and implications of augmented reality, virtual reality, and mixed reality for immersive learning in health professions education. Adv Simul (Lond) 2024; 9:36. [PMID: 39252139 PMCID: PMC11382381 DOI: 10.1186/s41077-024-00311-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 08/29/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND Augmented Reality (AR), Virtual Reality (VR) and Mixed Reality (MR) are emerging technologies that can create immersive learning environments for health professions education. However, there is a lack of systematic reviews on how these technologies are used, what benefits they offer, and what instructional design models or theories guide their use. AIM This scoping review aims to provide a global overview of the usage and potential benefits of AR/VR/MR tools for education and training of students and professionals in the healthcare domain, and to investigate whether any instructional design models or theories have been applied when using these tools. METHODOLOGY A systematic search was conducted in several electronic databases to identify peer-reviewed studies published between and including 2015 and 2020 that reported on the use of AR/VR/MR in health professions education. The selected studies were coded and analyzed according to various criteria, such as domains of healthcare, types of participants, types of study design and methodologies, rationales behind the use of AR/VR/MR, types of learning and behavioral outcomes, and findings of the studies. The (Morrison et al. John Wiley & Sons, 2010) model was used as a reference to map the instructional design aspects of the studies. RESULTS A total of 184 studies were included in the review. The majority of studies focused on the use of VR, followed by AR and MR. The predominant domains of healthcare using these technologies were surgery and anatomy, and the most common types of participants were medical and nursing students. The most frequent types of study design and methodologies were usability studies and randomized controlled trials. The most typical rationales behind the use of AR/VR/MR were to overcome limitations of traditional methods, to provide immersive and realistic training, and to improve students' motivations and engagements. The most standard types of learning and behavioral outcomes were cognitive and psychomotor skills. The majority of studies reported positive or partially positive effects of AR/VR/MR on learning outcomes. Only a few studies explicitly mentioned the use of instructional design models or theories to guide the design and implementation of AR/VR/MR interventions. DISCUSSION AND CONCLUSION The review revealed that AR/VR/MR are promising tools for enhancing health professions education, especially for training surgical and anatomical skills. However, there is a need for more rigorous and theory-based research to investigate the optimal design and integration of these technologies in the curriculum, and to explore their impact on other domains of healthcare and other types of learning outcomes, such as affective and collaborative skills. The review also suggested that the (Morrison et al. John Wiley & Sons, 2010) model can be a useful framework to inform the instructional design of AR/VR/MR interventions, as it covers various elements and factors that need to be considered in the design process.
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Affiliation(s)
- Maryam Asoodar
- School of Health Professions Education, Department of Educational Development and Research, Faculty of Health, Medicine and Life sciences, Maastricht University, Universiteitssingel 60, Maastricht, 6229 MD, The Netherlands.
| | - Fatemeh Janesarvatan
- School of Health Professions Education, Department of Educational Development and Research, Faculty of Health, Medicine and Life sciences, Maastricht University, Universiteitssingel 60, Maastricht, 6229 MD, The Netherlands
- School of Business and Economics, Educational Research and Development Maastricht University, Maastricht, The Netherlands
| | - Hao Yu
- School of Health Professions Education, Department of Educational Development and Research, Faculty of Health, Medicine and Life sciences, Maastricht University, Universiteitssingel 60, Maastricht, 6229 MD, The Netherlands
| | - Nynke de Jong
- School of Health Professions Education, Department of Educational Development and Research, Faculty of Health, Medicine and Life sciences, Maastricht University, Universiteitssingel 60, Maastricht, 6229 MD, The Netherlands
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Wolf M, Mergen M, Winter P, Landgraeber S, Orth P. Revolutionizing medical education: Surgery takes the lead in virtual reality research. Surg Open Sci 2024; 20:151-155. [PMID: 39886064 PMCID: PMC11780391 DOI: 10.1016/j.sopen.2024.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 06/13/2024] [Accepted: 06/29/2024] [Indexed: 02/01/2025] Open
Abstract
Objectives Advancements in technology have spurred a transformative shift in medical education, with virtual reality (VR) emerging as a powerful tool for enhancing the learning experience. This study analyses the publications of VR in medical education, focusing on differences within different medical specialties. Design Using specific search terms, all studies published on VR in medical education listed in the Web of Science databases were included. All identified publications were analysed in order to draw comparative conclusions regarding their qualitative and quantitative scientific merit. Results Since the first publication in 1993 and until the year 2022, there have been 1534 publications on VR in medical education. Over the years, the annual publication rate has increased almost exponentially. The studies have in total been cited 42,655 times (average 27.64 citations/publication). The leading medical field was surgery (415 publications), followed by internal medicine (117 publications), neurology (77 publications) and radiology and nuclear medicine (75 publications). Internationally, the United States (560 publications), the United Kingdom (179 publications), Canada (156 publications), Germany (139 publications) and China (100 publications) are the leading countries in this field. 37.1 % of the publications reported having received funding. Among the 100 organizations with the highest number of grants, only 8 were private companies. Conclusion During the last 30 years, there has been a consistent rise in publications, with a notable surge observed in 2016 and 2020. The majority of the studies centered on surgical concerns. However, only a small proportion received financial support, which was particularly evident for funding originating from the private sector.
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Affiliation(s)
- M.A. Wolf
- Department of Orthopedics, Saarland University, Kirrberger Straße 100, 66421 Homburg, Saarland, Germany
| | - M. Mergen
- Department of Pediatric Oncology and Hematology, Saarland University, Kirrberger Straße 100, 66421 Homburg, Saarland, Germany
| | - P. Winter
- Department of Orthopedics, Saarland University, Kirrberger Straße 100, 66421 Homburg, Saarland, Germany
| | - S. Landgraeber
- Department of Orthopedics, Saarland University, Kirrberger Straße 100, 66421 Homburg, Saarland, Germany
| | - P. Orth
- Department of Orthopedics, Saarland University, Kirrberger Straße 100, 66421 Homburg, Saarland, Germany
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Hernández-Xumet JE, García-Hernández AM, Fernández-González JP, Marrero-González CM. Exploring levels of empathy and assertiveness in final year physiotherapy students during clinical placements. Sci Rep 2024; 14:13349. [PMID: 38858441 PMCID: PMC11164891 DOI: 10.1038/s41598-024-64148-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 06/05/2024] [Indexed: 06/12/2024] Open
Abstract
Empathy and assertiveness are two essential soft skills for any healthcare professional's competence and ethical development. It has been shown that empathy can be influenced throughout the training of a future healthcare professional, particularly during the clinical placement period. This research aims to assess fourth-year physiotherapy students' empathic and assertive development before and after clinical placement. A longitudinal observational study was conducted with fourth-year physiotherapy students during the academic year 2022/2023. A preliminary assessment of empathy and assertiveness levels was carried out before the start of the clinical placement and at the end of the placement using the Individual Reactivity Index to assess empathy and the Rathus Test to assess assertiveness. The results show a statistically significant difference (p ≤ 0.05) in both the empathy subscales of perspective-taking and empathic-concern between the pre- and postassessment, as well as an inverse correlation between the empathy subscale of personal distress and assertiveness. It is concluded that students show adequate results in empathy and assertiveness. However, there is some influence of clinical practice on the development of empathy, and future intervention studies need to be considered. Furthermore, students with higher levels of assertiveness have lower levels of personal distress, suggesting that assertiveness is closely related to empathy.
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Affiliation(s)
- Juan-Elicio Hernández-Xumet
- Movement and Health Research Group, Departamento de Medicina Física y Farmacología, Facultad de Ciencias de La Salud, Universidad de La Laguna (ULL), La Laguna, Spain.
- Hospital Universitario Nuestra Señora de Candelaria, Servicio Canario de La Salud, Santa Cruz de Tenerife, Spain.
| | | | - Jerónimo-Pedro Fernández-González
- Movement and Health Research Group, Departamento de Medicina Física y Farmacología, Facultad de Ciencias de La Salud, Universidad de La Laguna (ULL), La Laguna, Spain
- Gerencia de Atención Primaria de Tenerife, Servicio Canario de La Salud, Santa Cruz de Tenerife, Spain
| | - Cristo-Manuel Marrero-González
- Movement and Health Research Group, Departamento de Medicina Física y Farmacología, Facultad de Ciencias de La Salud, Universidad de La Laguna (ULL), La Laguna, Spain
- Departamento de Enfermería, Facultad de Ciencias de La Salud, Universidad de La Laguna (ULL), La Laguna, Spain
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Dương TQ, Soldera J. Virtual reality tools for training in gastrointestinal endoscopy: A systematic review. Artif Intell Gastrointest Endosc 2024; 5:92090. [DOI: 10.37126/aige.v5.i2.92090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/11/2024] [Accepted: 04/07/2024] [Indexed: 05/11/2024] Open
Abstract
BACKGROUND Virtual reality (VR) has emerged as an innovative technology in endoscopy training, providing a simulated environment that closely resembles real-life scenarios and offering trainees a valuable platform to acquire and enhance their endoscopic skills. This systematic review will critically evaluate the effectiveness and feasibility of VR-based training compared to traditional methods.
AIM To evaluate the effectiveness and feasibility of VR-based training compared to traditional methods. By examining the current state of the field, this review seeks to identify gaps, challenges, and opportunities for further research and implemen-tation of VR in endoscopic training.
METHODS The study is a systematic review, following the guidelines for reporting systematic reviews set out by the PRISMA statement. A comprehensive search command was designed and implemented and run in September 2023 to identify relevant studies available, from electronic databases such as PubMed, Scopus, Cochrane, and Google Scholar. The results were systematically reviewed.
RESULTS Sixteen articles were included in the final analysis. The total number of participants was 523. Five studies focused on both upper endoscopy and colonoscopy training, two on upper endoscopy training only, eight on colon-oscopy training only, and one on sigmoidoscopy training only. Gastro-intestinal Mentor virtual endoscopy simulator was commonly used. Fifteen reported positive results, indicating that VR-based training was feasible and acceptable for endoscopy learners. VR technology helped the trainees enhance their skills in manipulating the endoscope, reducing the procedure time or increasing the technical accuracy, in VR scenarios and real patients. Some studies show that the patient discomfort level decreased significantly. However, some studies show there were no significant differences in patient discomfort and pain scores between VR group and other groups.
CONCLUSION VR training is effective for endoscopy training. There are several well-designed randomized controlled trials with large sample sizes, proving the potential of this innovative tool. Thus, VR should be more widely adopted in endoscopy training. Furthermore, combining VR training with conventional methods could be a promising approach that should be implemented in training.
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Affiliation(s)
- Tuấn Quang Dương
- Department of Acute Medicine, University of South Wales, Cardiff CF37 1DL, United Kingdom
| | - Jonathan Soldera
- Department of Acute Medicine and Gastroenterology, University of South Wales, Cardiff CF37 1DL, United Kingdom
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18
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Teodorczuk A, Abdool PS, Yap CX, Fisher JM. New horizons in undergraduate geriatric medicine education. Age Ageing 2024; 53:afae050. [PMID: 38688484 DOI: 10.1093/ageing/afae050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Indexed: 05/02/2024] Open
Abstract
Current projections show that between 2000 and 2050, increasing proportions of older individuals will be cared for by a smaller number of healthcare workers, which will exacerbate the existing challenges faced by those who support this patient demographic. This review of a collection of Age and Ageing papers on the topic in the past 10 years explores (1) what best practice geriatrics education is and (2) how careers in geriatrics could be made more appealing to improve recruitment and retention. Based on these deeper understandings, we consider, as clinician educators, how to close the gap both pragmatically and theoretically. We point out paradigm shifting solutions that include innovations at the Undergraduate level, use of simulation, incorporation of learner and patient perspectives, upskilling professionals outside of Geriatrics and integration of practice across disciplines through Interprofessional Learning. We also identify an education research methodological gap. Specifically, there is an abundance of simple descriptive or justification studies but few clarification education studies; the latter are essential to develop fresh insights into how Undergraduate students can learn more effectively to meet the needs of the global ageing challenge. A case of improving understanding in delirium education is presented as an illustrative example of a new approach to exploring at greater depth education and outlines suggested directions for the future.
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Affiliation(s)
- Andrew Teodorczuk
- Northside Clinical Unit, The Medical School, The University of Queensland, Brisbane, Qld, Australia
- The Prince Charles Hospital, Metro North Mental Health, Brisbane, Qld, Australia
- School of Medicine and Dentistry, Griffith University, Southport, Qld, Australia
- School of Nursing, QUT, Brisbane, Qld, Australia
| | - Petal S Abdool
- Geriatric Mental Health Service, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Chloe X Yap
- The Prince Charles Hospital, Metro North Mental Health, Brisbane, Qld, Australia
- Mater Research Institute, The University of Queensland, Brisbane, Qld, Australia
| | - James M Fisher
- Department of Geriatric Medicine, Northumbria Healthcare NHS Foundation Trust, North Tyneside, UK
- School of Medicine, Newcastle University, Newcastle upon Tyne, UK
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Lechner BE, Kukora SK, Hawes K. Equity, inclusion and cultural humility: contemporizing the neonatal intensive care unit family-centered care model. J Perinatol 2024; 44:760-766. [PMID: 38532086 DOI: 10.1038/s41372-024-01949-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/29/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
Existing NICU family centered care models lack the key elements of equity, inclusion and cultural humility. These models were conceived to support families during the stressful life event of an infant's NICU admission. Their development, however, occurred prior to recognition of the medical field's systematic shortcomings in providing equitable care and their impact on outcome disparities for marginalized communities; thus, they do not include cultural or equitable healthcare considerations. Given the significant neonatal care inequities for marginalized groups, incorporating the experience of these patients in a targeted manner into family centered care frameworks is of critical importance to ensure culturally humble and thus more just and equitable treatment. Here, we review past approaches to NICU family centered care and propose a novel, updated framework which integrates culturally humble care into the NICU family centered care framework.
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Affiliation(s)
- Beatrice E Lechner
- Division of Neonatology, Women & Infants Hospital of Rhode Island, Providence, RI, USA.
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA.
| | - Stephanie K Kukora
- Division of Neonatology and Bioethics Center, Children's Mercy Hospital, Kansas City, MO, USA
- Department of Pediatrics and Department of Medical Humanities and Bioethics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Katheleen Hawes
- Division of Neonatology, Women & Infants Hospital of Rhode Island, Providence, RI, USA
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA
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20
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Garza KB, Davis B, Kelley J, Richardson A, Seals C, Hawkins G, McGuckin L, Rose CG, Grabowsky A. Assessing the effectiveness of virtual reality to promote empathy for patients through a mixed-methods study. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100702. [PMID: 38688454 DOI: 10.1016/j.ajpe.2024.100702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/14/2024] [Accepted: 04/23/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE To describe the implementation and outcomes of EmpathyVR, an immersive experience using virtual reality (VR) to promote empathy for patients with physical limitations due to chronic diseases. METHODS First-year student pharmacists participated in a learning experience that incorporated VR and stiff gloves to simulate physical limitations associated with color-blindness and arthritis, respectively. Students completed pre- and post-intervention surveys that included the Kiersma-Chen Empathy Scale and measures of immersion, user enjoyment, perceived usefulness for learning, and adverse effects of the experience. A focus group was also conducted with 6 students to obtain additional feedback on the learning experience. RESULTS Of the 132 students who were enrolled in the program, 131 completed the assigned tasks; 117 of these agreed to participate in the study, and their data were included in the analyses. There was a significant improvement in empathy scores in the cognitive domain from pre- to post-intervention. Post-intervention survey results also demonstrated a high degree of immersion in the experience, high levels of self-reported enjoyment, and high levels of perceived usefulness of the activity to support learning. There was a low to moderate incidence of minor self-reported adverse effects from the activity. Focus group feedback was also positive. One student stated, "… it really allowed you to think and put yourself in their shoes." CONCLUSION Implementation of a VR-based learning activity into the first semester of the PharmD curriculum was successful and resulted in improved student empathy scores and a positive learning experience.
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Affiliation(s)
- Kimberly B Garza
- Auburn University, Health Outcomes Research and Policy, Auburn, AL, USA.
| | - Brandy Davis
- Auburn University, Health Outcomes Research and Policy, Auburn, AL, USA
| | - Jacob Kelley
- Auburn University, Educational Foundations, Leadership, and Technology, Auburn, AL, USA
| | - Alexicia Richardson
- Auburn University, Computer Science and Software Engineering, Auburn, AL, USA
| | - Cheryl Seals
- Auburn University, Computer Science and Software Engineering, Auburn, AL, USA
| | | | | | - Chad G Rose
- Auburn University, Mechanical Engineering, Auburn, AL, USA
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Li Y(J, Orlosky J, Jirau-Rosaly W, Brown S, Rockich-Winston N. Immersing healthcare students in a virtual reality Parkinson's disease experience. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2024; 15:34-36. [PMID: 38554134 PMCID: PMC11288618 DOI: 10.5116/ijme.65f5.725c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/16/2024] [Indexed: 04/01/2024]
Affiliation(s)
- Yi (Joy) Li
- Kennesaw State University, Department of Software Engineering & Game Development, Marietta, Georgia, USA
| | - Jason Orlosky
- Augusta University, Department of Computer & Cyber Sciences, Augusta, Georgia, USA, and Osaka University, Cybermedia Center, Toyonaka, Japan
| | - Wanda Jirau-Rosaly
- Medical College of Georgia at Augusta University, Department of Medicine, Augusta, Georgia, USA
| | - Shilpa Brown
- Medical College of Georgia at Augusta University, Department of Medicine, Augusta, Georgia, USA
| | - Nicole Rockich-Winston
- Medical College of Georgia at Augusta University, Department of Pharmacology and Toxicology, Augusta, Georgia, USA
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22
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Fu Y, Chu F, Lu X, Wang C, Xiao N, Jiang J, Zheng J, Jiang H. Assessment and evaluation of online education and virtual simulation technology in dental education: a cross-sectional survey. BMC MEDICAL EDUCATION 2024; 24:191. [PMID: 38403582 PMCID: PMC10895829 DOI: 10.1186/s12909-024-05171-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND The global outbreak of coronavirus disease (COVID-19) has led medical universities in China to conduct online teaching. This study aimed to assess the effectiveness of a blended learning approach that combines online teaching and virtual reality technology in dental education and to evaluate the acceptance of the blended learning approach among dental teachers and students. METHODS The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was followed in this study. A total of 157 students' perspectives on online and virtual reality technology education and 54 teachers' opinions on online teaching were collected via questionnaires. Additionally, 101 students in the 2015-year group received the traditional teaching method (TT group), while 97 students in the 2017-year group received blended learning combining online teaching and virtual reality technology (BL group). The graduation examination results of students in the two groups were compared. RESULTS The questionnaire results showed that most students were satisfied with the online course and the virtual simulation platform teaching, while teachers held conservative and neutral attitudes toward online teaching. Although the theoretical score of the BL group on the final exam was greater than that of the TT group, there was no significant difference between the two groups (P = 0.805). The skill operation score of the BL group on the final exam was significantly lower than that of the TT group (P = 0.004). The overall score of the BL group was lower than that of the TT group (P = 0.018), but the difference was not statistically significant (P = 0.112). CONCLUSIONS The blended learning approach combining online teaching and virtual reality technology plays a positive role in students' learning and is useful and effective in dental education.
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Affiliation(s)
- Yu Fu
- Oral and Maxillofacial Surgery Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Fengqing Chu
- Department of Teaching Office of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
- Department of Basic Science of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Xiaoqing Lu
- Department of Teaching Office of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Chenxing Wang
- Oral and Maxillofacial Surgery Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Na Xiao
- Oral and Maxillofacial Surgery Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Jiajia Jiang
- Department of Teaching Office of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Jue Zheng
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China.
| | - Hongbing Jiang
- Oral and Maxillofacial Surgery Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.
- Department of Teaching Office of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.
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Liu JYW, Mak PY, Chan K, Cheung DSK, Cheung K, Fong KNK, Kor PPK, Lai TKH, Maximo T. The Effects of Immersive Virtual Reality-Assisted Experiential Learning on Enhancing Empathy in Undergraduate Health Care Students Toward Older Adults With Cognitive Impairment: Multiple-Methods Study. JMIR MEDICAL EDUCATION 2024; 10:e48566. [PMID: 38358800 PMCID: PMC10905348 DOI: 10.2196/48566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/08/2023] [Accepted: 12/28/2023] [Indexed: 02/16/2024]
Abstract
BACKGROUND Immersive virtual reality (IVR)-assisted experiential learning has the potential to foster empathy among undergraduate health care students toward older adults with cognitive impairment by facilitating a sense of embodiment. However, the extent of its effectiveness, including enhancing students' learning experiences and achieving intended learning outcomes, remains underexplored. OBJECTIVE This study aims to evaluate the impacts of IVR-assisted experiential learning on the empathy of undergraduate health care students toward older people with cognitive impairment as the primary outcome (objective 1) and on their learning experience (objective 2) and their attainment of learning outcomes as the secondary outcomes (objective 3). METHODS A multiple-methods design was used, which included surveys, focus groups, and a review of the students' group assignments. Survey data were summarized using descriptive statistics, whereas paired 2-tailed t tests were used to evaluate differences in empathy scores before and after the 2-hour IVR tutorial (objective 1). Focus groups were conducted to evaluate the impacts of IVR-assisted experiential learning on the empathy of undergraduate health care students toward older people with cognitive impairment (objective 1). Descriptive statistics obtained from surveys and thematic analyses of focus groups were used to explore the students' learning experiences (objective 2). Thematic analysis of group assignments was conducted to identify learning outcomes (objective 3). RESULTS A total of 367 undergraduate nursing and occupational therapy students were recruited via convenience sampling. There was a significant increase in the students' empathy scores, measured using the Kiersma-Chen Empathy Scale, from 78.06 (SD 7.72) before to 81.17 (SD 8.93) after (P<.001). Students expressed high satisfaction with the IVR learning innovation, with a high satisfaction mean score of 20.68 (SD 2.55) and a high self-confidence mean score of 32.04 (SD 3.52) on the Student Satisfaction and Self-Confidence scale. Students exhibited a good sense of presence in the IVR learning environment, as reflected in the scores for adaptation (41.30, SD 6.03), interface quality (11.36, SD 3.70), involvement (62.00, SD 9.47), and sensory fidelity (31.47, SD 5.23) on the Presence Questionnaire version 2.0. In total, 3 major themes were identified from the focus groups, which involved 23 nursing students: enhanced sympathy toward older adults with cognitive impairment, improved engagement in IVR learning, and confidence in understanding the key concepts through the learning process. These themes supplement and align with the survey results. The analysis of the written assignments revealed that students attained the learning outcomes of understanding the challenges faced by older adults with cognitive impairment, the importance of providing person-centered care, and the need for an age-friendly society. CONCLUSIONS IVR-assisted experiential learning enhances students' knowledge and empathy in caring for older adults with cognitive impairment. These findings suggest that IVR can be a valuable tool in professional health care education.
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Affiliation(s)
- Justina Yat Wa Liu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Pui Ying Mak
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Kitty Chan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Daphne Sze Ki Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Kin Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Kenneth N K Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Patrick Pui Kin Kor
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Timothy Kam Hung Lai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Tulio Maximo
- School of Design, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
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24
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Khodabakhshian N, Gaeul Lee K, Marawi T, Sorkhou M, Vyravanathan S, Harnett N. Virtual Reality for Developing Patient-Facing Communication Skills in Medical and Graduate Education: Protocol for a Scoping Review. JMIR Res Protoc 2024; 13:e53901. [PMID: 38300671 PMCID: PMC10870214 DOI: 10.2196/53901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Clinician-patient communication is an integral component in providing quality medical care. However, research on clinician-patient communication has shown overall patient discontent with provider communication skills. While virtual reality (VR) is readily used for procedural-based learning in medical education, its potential for teaching patient-facing communication skills remains unexplored. This scoping review aims to evaluate the effectiveness and feasibility of VR applications used for patient-facing communication skills development in medical education. OBJECTIVE The primary objective is to synthesize and evaluate the effectiveness of available VR tools and applications used for patient-facing communication skills development in medical education. The secondary objectives are to (1) assess the feasibility of adapting VR applications to develop patient-facing communication skills in medical education and (2) provide an overview of the challenges associated with adapting VR applications to develop patient-facing communication skills in medical education. METHODS A total of 4 electronic databases (ERIC, Embase, PubMed, and MEDLINE) were searched for primary peer-reviewed articles published through April 11, 2023. Articles evaluating the implementation of non-, semi-, and fully immersive VR training for patient- or caregiver-facing communication skills training provided to graduate, medical, or other allied health care professions students were included. Studies that assessed augmented reality, mixed reality, artificial intelligence, or VR for non-communication-based training were excluded. Study selection will include a title, abstract, and full-text screening by 4 authors. Data from eligible studies will be extracted and entered into a database and presented in tabular format. Findings will be reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for scoping reviews. RESULTS As of April 11, 2023, the search strategy has been confirmed and the search has been completed. We are currently at the title and abstract screening stage. Once complete, the articles will undergo full-text screening according to eligibility criteria as described in the methods. CONCLUSIONS The findings of this review will inform the development of a graduate-level clinical skills research course within the Institute of Medical Science graduate department at the University of Toronto. It is also expected that these findings will be of interest to other health care-specific faculties inside and beyond our institution. Further, our scoping review will summarize the limited field of literature on VR use in medical communications training and identify areas for future inquiry. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53901.
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Affiliation(s)
- Nairy Khodabakhshian
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Kyla Gaeul Lee
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Sinai Health, Toronto, ON, Canada
| | - Tulip Marawi
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Sunnybrook Research Institute, Toronto, ON, Canada
| | - Maryam Sorkhou
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Addictions Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Nicole Harnett
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
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25
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Lembo D, Abate Daga F, Calì C, Garbossa D, Manfredi M, Odetto L, Ostacoli L, Paccotti P, Raimondo S, Reimondo G, Sciascia S. Early introduction of simulation in the medical curriculum: the MedInTo perspective. Front Med (Lausanne) 2024; 10:1280592. [PMID: 38239607 PMCID: PMC10794325 DOI: 10.3389/fmed.2023.1280592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/22/2023] [Indexed: 01/22/2024] Open
Abstract
Despite the increasing body of evidence supporting the use of simulation in medicine, a question remains: when should we introduce it into the medical school's curriculum? We present the experience and future perspectives of the MD program in Medicine and Surgery of University of Turin-MedInTo. Since its launch, MedInTo has been dedicated to integrating innovative teaching approaches at the early stages into the medical curriculum. Herewith, we describe a case-based approach for our activities, which includes the utilization of simulation for emergency medical care training for students and the integration of virtual and augmented reality technology. Dedicated surgical training activities using virtual-augmented reality and life-like simulator for students are also described.
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Affiliation(s)
- David Lembo
- MD Program in Medicine and Surgery of University of Turin-MedInTo, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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26
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Chou CH, Tai HC, Chen SL. The effects of introducing virtual reality communication simulation in students' learning in a fundamentals of nursing practicum: A pragmatic randomized control trials. Nurse Educ Pract 2024; 74:103837. [PMID: 38006647 DOI: 10.1016/j.nepr.2023.103837] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/12/2023] [Accepted: 11/03/2023] [Indexed: 11/27/2023]
Abstract
AIM This study was conducted to examine the effectiveness of a virtual reality communication simulation (VRCS) in teaching communication skills in fundamentals of nursing practicum. BACKGROUND Effective communication skills are an integral part of the nursing profession and the foundation of high-quality nursing care. Effective communication not only addresses the needs of patients but is also necessary for maintaining patient safety. Many studies have reported the inadequacy of nursing students in communicating with patients. Nursing students often experience stress due to their lack of adequate skills to communicate effectively with patients and their family members. DESIGN A pragmatic randomized controlled trial research with four within-subjects assessments (at the baseline (T0), 1st week (T1) and 3rd week (T2) of the clinical practice and 1 week after the end of the clinical practice (T3)) and between-subjects assessments. SETTINGS AND PARTICIPANTS Eighty-four nursing students at a university of Science and Technology in central Taiwan. METHODS The students were randomly assigned to an experimental group (n = 42) and a control group (n = 42). The experimental group received a VRCS, whereas the control group received the nurse-patient communication teaching video. The data were collected from April 2022 to August 2022. The Kalamazoo Essential Element Communication Checklist, Communication Self-Assessment Scale, Learning Satisfaction Questionnaire and Stress Scale for Nursing Students in Clinical Practice were used for data collection. RESULTS At baseline, the control group had higher scores on communication ability and confidence compared with the experimental group (t = -3.91, p <.001; and t = -2.35, p =.021). In the first week of clinical practice, the experimental group had significantly higher mean scores for communication ability compared with the control group (β = 15.99, 95 % confidence interval [CI] 13.79, 18.18) and communication confidence and learning satisfaction compared with controls at T1, T2 and T3 of the clinical practice (all, p <.001). The clinical practice stress scores of the experimental group were significantly lower than those of the control group at T1, T2 and T3 of the clinical practice (all, p <.05). CONCLUSIONS The newly developed VRCS is acceptable and worthwhile for training nursing students to develop communication abilities. This study suggests that VRCS practice should be arranged as early as possible in fundamentals of nursing practice courses and before the fundamentals of nursing practicum so as to facilitate the learning of effective communication. Follow-up research is needed to evaluate the long-term effects of virtual reality education in nursing practice.
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Affiliation(s)
- Chia-Hui Chou
- Department of Nursing, Hungkuang University, No.34, Chung-Chie Rd, Shalu, Taichung County 43302, Taiwan, ROC
| | - Hui-Chen Tai
- Department of Nursing, Hungkuang University, No.34, Chung-Chie Rd, Shalu, Taichung County 43302, Taiwan, ROC
| | - Shu-Ling Chen
- Department of Nursing, Hungkuang University, No.34, Chung-Chie Rd, Shalu, Taichung County 43302, Taiwan, ROC.
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27
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Flood LS. Use of Virtual Reality Simulations to Embody a Patient: Exploring the Impact on Nursing Students' Confidence, Feelings, and Perceptions. Nurse Educ 2024; 49:36-40. [PMID: 37229702 DOI: 10.1097/nne.0000000000001442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Using immersive virtual reality (VR), students are able to physically and emotionally embody patients while interacting in simulated environments with family and health care providers. PURPOSE This pilot study explored how embodying patients with Alzheimer disease and terminal cancer at end of life using highly immersive VR impacted nursing students' confidence, feelings, and perceptions. METHODS A quasi-experimental design was used with a convenience sample of bachelor of science in nursing students who completed pre/posttest scaled and open-ended questions. RESULTS Participants (N = 32) reported significant confidence increases; feelings about dying and hospice were also significantly changed. The majority described how the simulations would impact their future nursing care. CONCLUSION Using VR, students experienced disease, dying, and health care from the patient's perspective reporting differences in confidence, feelings, and perceptions. Immersive VR simulations warrant further study and have the potential to transform nursing education and impact health care.
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Affiliation(s)
- Lisa Sue Flood
- Professor, School of Nursing, Northern Michigan University, Marquette
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28
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Mistry D, Brock CA, Lindsey T. The Present and Future of Virtual Reality in Medical Education: A Narrative Review. Cureus 2023; 15:e51124. [PMID: 38274907 PMCID: PMC10810257 DOI: 10.7759/cureus.51124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 12/20/2023] [Indexed: 01/27/2024] Open
Abstract
Virtual reality (VR) uses computer-generated and three-dimensional environments to create immersive experiences through the use of interactive devices that simulate virtual environments in many forms, such as 3D, screen-based, or room-based. Users can engage in the environment with objects, characters, and scenes, making individuals assume they are experiencing a real-life scenario. VR has been adopted across medical and nursing fields to supplement clinically relevant and practical teaching. However, the effectiveness of this interactive form of learning has come a long way with improvements in accessibility, cost, and technicalities. The immersive simulated environment that VR has to offer today initially began with screen-based learning and then the 360-video method. These previously sought-out methods were eventually found to disconnect the students from engaging in the learning environment that present-day VR systems are designed to provide. Interactive VR offers a dynamic platform for medical training. These simulations benefit the learner by allowing them to interact within case scenarios and virtual wards, as well as with patients, colleagues, and relatives. To mimic real-life encounters, the student can take a patient's history and physical exam, investigate, diagnose, and provide treatment. The simulated patient can express emotions, concerns, and signs of a poor state of health. All these factors play into a healthcare provider's competency to think critically and clinically in decision-making. This practice is now being used in many surgical programs and medical education curricula. The use of simulation in VR is continuously being proven to decrease injury, increase operation speed, and improve overall outcomes in patient-centered care. VR simulation differs from in-person simulation training in that the VR modality of learning is more accessible and replicable than the latter. By comparing research studies and reviews of medical programs that incorporated VR into their curricula, we were able to assess the state of VR in medical education and where this technology could lead to future implementation in medical programs. Our review aimed to give insight into the existing evidence, the gaps in the use of VR in medical education, and the potential benefits this modality of learning can have going forward in this field of study. Medical students have demonstrated significantly enhanced knowledge gain when using immersive interactive VR over screen-based learning. Given the improvements in students' performance due to these dynamic and collaborative learning experiences, immersive VR training will become a standard in the development of clinical skills and ensure patient safety. Although the emphasis on empathy began later in the journey of gaining VR as a part of medical education, there is a need to gain those skills as early as possible in medical school. Implementing the use of VR as a supplement in medical education allows students to practice simulated patient encounters along with an array of different academic endeavors. By doing so, students will gain competency and confidence as they encounter patients during their clinical rotations and clinical practice.
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Affiliation(s)
- Dipal Mistry
- Medicine, Edward Via College of Osteopathic Medicine (VCOM) Carolinas, Spartanburg, USA
| | - Callaham A Brock
- Medicine, Edward Via College of Osteopathic Medicine (VCOM) Carolinas, Spartanburg, USA
| | - Tom Lindsey
- Simulation and Technology/Surgery, Edward Via College of Osteopathic Medicine (VCOM) Carolinas, Spartansburg, USA
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29
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Beckstrom KM, Farrow SL. The effects of empathic communication skills training on nurse practitioner students. J Am Assoc Nurse Pract 2023:01741002-990000000-00185. [PMID: 37972939 DOI: 10.1097/jxx.0000000000000972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/10/2023] [Indexed: 11/19/2023]
Abstract
ABSTRACT Evidence regarding the impact of empathic communication training on nurse practitioner (NP) students is lacking. Despite increasing emphasis within practice settings in the United States, formal communication training for NP students has been modestly integrated into curriculum, based on limited data supporting its efficacy. As such, we sought to evaluate the impact of empathic communication training on NP students' self-efficacy with empathic communication. This is a quasi-experimental study of a single group of NP students (n = 49) who participated in empathic communication training with pretraining/posttraining measurements using the Self-Efficacy-12 instrument. There were statistically significant improvements in students' comfort and confidence with nine of the 17 items surveyed. Several other domains also showed improvement approaching statistical significance. Based on our results, empathic communication training increases NP students' self-efficacy with empathic communication.
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Affiliation(s)
- Kimberly M Beckstrom
- Nurse Practitioner Clinical Education Program, Mayo Clinic School of Health Sciences, Rochester, Minnesota
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30
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Krause KJ, Mullins DD, Kist MN, Goldman EM. Developing 3D models using photogrammetry for virtual reality training in anatomy. ANATOMICAL SCIENCES EDUCATION 2023; 16:1033-1040. [PMID: 37248365 DOI: 10.1002/ase.2301] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/31/2023]
Abstract
Virtual reality (VR) is an increasingly available resource with numerous applications to medical education, and as a teaching tool has been widely validated in the literature. Photogrammetry, the process of overlapping two-dimensional (2D) photographic images of three-dimensional (3D) objects to create a 3D image or "model," can be used in conjunction with VR to create pedagogically sound learning modules for anatomy education. However, to date, there has not been a detailed description of the process of developing and implementing an in-house VR tool to supplement anatomy instruction. In this article, we examine the methods, benefits, and challenges of using photogrammetry to implement a VR classroom that capitalizes on the strengths of a traditional body donor-based course and the unique strengths of VR. Using off-the-shelf equipment, developing VR content and a VR curriculum is both feasible and approachable for medical educators.
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Affiliation(s)
- Kayla J Krause
- Department of Radiology, The Pennsylvania State University College of Medicine, Pennsylvania, Hershey, USA
| | - Drew D Mullins
- Department of Radiology, The Pennsylvania State University College of Medicine, Pennsylvania, Hershey, USA
| | - Madison N Kist
- Department of Radiology, The Pennsylvania State University College of Medicine, Pennsylvania, Hershey, USA
| | - Evan M Goldman
- Department of Radiology, The Pennsylvania State University College of Medicine, Pennsylvania, Hershey, USA
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31
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Wardian JL, Wells TM, Cochran TM. Creating Patient Context: Empathy and Attitudes Toward Diabetes Following Virtual Immersion. J Diabetes Sci Technol 2023; 17:1172-1180. [PMID: 37231650 PMCID: PMC10563534 DOI: 10.1177/19322968231174441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Pandemic circumstances created challenges for doctor of physical therapy (DPT) students to understand social determinants of health (SDH) in clinical rotations. Instead of canceling clinical rotations, a virtual reality cinema (cine-VR) education series was implemented. The purpose of this project is to describe the effect of this simulated immersion on student empathy and attitudes toward diabetes. METHOD The DPT students (n=59) participated in 12 cine-VR education modules, completing surveys at three time points as part of coursework. The students completed baseline measures of the Diabetes Attitude Scale-Version 3 (DAS-3) and Jefferson Empathy Scale (JES), and then were immersed in 12 cine-VR modules. One week after module completion, students participated in a class discussion about the modules. The students repeated the JES and DAS-3 scales at postclass and six weeks later. Three subscales from the Presence Questionnaire (PQ) were used to measure the virtual experience. RESULTS Student scores on three DAS-3 subscales significantly improved on posttest: Attitude toward patient autonomy, Mean: 0.75, SD: 0.45; t(58) = 12.742, P < .001; Psychosocial impact of diabetes, Mean: -0.21, SD: 0.41; t(58) = -3.854, P < .001; and Seriousness of type 2 diabetes, Mean: -039, SD: 0.44; t(58) = -6.780, P < .001, with lower scores six weeks later. Student scores increased on the JES and remained high (P < .001). High subscale scores on the PQ demonstrated immersion and involvement in the virtual experience. DISCUSSION These modules can allow for a shared student experience that improves diabetes attitudes, increases empathy, and fosters meaningful classroom discussion. The cine-VR experience is flexible, and modules allow students to engage in aspects of a patient's life that were not available otherwise.
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Affiliation(s)
- Jana L. Wardian
- Division of Hospital Medicine,
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE,
USA
| | - Tessa M. Wells
- Division of Physical Therapy Education,
Department of Health & Rehabilitation Sciences, University of Nebraska Medical
Center, Omaha, NE, USA
| | - Teresa M. Cochran
- Division of Physical Therapy Education,
Department of Health & Rehabilitation Sciences, University of Nebraska Medical
Center, Omaha, NE, USA
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32
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Tsai CM, Hsu TC, Hsieh CJ. A virtual reality intervention to improve formal caregivers' understanding of community-dwelling people with dementia: a pilot study. Contemp Nurse 2023; 59:334-343. [PMID: 37733898 DOI: 10.1080/10376178.2023.2259495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 09/09/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND The optimum approach to enhance the understanding toward dementia is to experience how patients feel as they experience the manifestations of the disease. The application of virtual reality (VR) and relevant innovative technologies for developing caregiver training programs allows caregivers to better understand dementia and empathize with patients. OBJECTIVES To develop a VR-based experiential training course on individualized care for the behavioral and psychological symptoms of dementia (BPSD). METHODS The participants were caregivers of patients with dementia. They assessed the usability of the VR product after the intervention and the VR experience as a preliminary measure of the effectiveness of the intervention using a usability scale and a self-reported appraisal scale, respectively. RESULTS AND CONCLUSION Ten in-service and in-home caregivers completed the VR training course. The course yielded a usability score of 74.06 points, indicating excellent usability. The content validity index (CVI) of the self-reported VR experience appraisal scale ranged from 0.8-1, scale-level CVI was 0.81, and reliability (Cronbach's α) was 0.929. The mean score of the overall scale was 4.67 ± 0.33. These findings suggest that the VR-based experiential training course enabled the home caregivers to deepen their understanding of the BPSD shown by community-dwelling patients and, therefore, to provide better care services. The course developed in this study is the first VR course directed toward dementia care in Taiwan. Given its excellent usability, as well as the effectiveness of the VR experience appraisal scale for deepening the caregivers' skills in managing patients' BPSD symptoms, the course can be promoted and applied in caregiver training programs for dementia in the future.
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Affiliation(s)
- Chia-Mei Tsai
- National Taipei University of Nursing and Health Sciences, Instructor, Nursing College of Fooyin University, Taiwan, Republic of China
| | - Tzu-Chi Hsu
- Department of Integrated Circuit Design and Automation, Innovation Frontier Institute of Research for Science and Technology, National Taipei University of Technology, Taiwan, Republic of China
| | - Chia-Jung Hsieh
- School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taiwan, Republic of China
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Kovanur Sampath K, Arumugam A, Yaghi E, Fairs E, Andersen P. Perception and knowledge of learners about the use of 3D technologies in manual therapy education - a qualitative study. BMC MEDICAL EDUCATION 2023; 23:509. [PMID: 37461000 DOI: 10.1186/s12909-023-04497-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 07/05/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVES Manual therapy is a specific hands-on approach used and taught by various professions such as physiotherapy and osteopathy. The current paradigm of teaching manual therapy incorporates the traditional 'See one, do one, teach one' approach. However, this 'teacher centred' approach may not enable learners to develop the complex clinical skills of manual therapy. In this context, 3D technologies such as virtual reality may facilitate the teaching and learning of manual therapy. Hence the aim of the current study was to investigate the perception, knowledge and attitude of manual therapy learners about the use of 3D technologies in manual therapy education. METHODS An exploratory qualitative research design using semi-structured interviews was used in this study. A total of ten manual therapy (5 physiotherapy and 5 osteopathic) students (mean age = 32; 80% female) enrolled in an appropriate physiotherapy or osteopathic degree provided by a New Zealand recognized institution (e.g., university or polytechnic) participated in this study. Data saturation was achieved after 10 interviews (average duration: 35 min) that provided thick data. A thematic analysis was used for data analysis. RESULTS Six factors were identified which appeared to influence participants' perception of role of technology in manual therapy education. These were (1) the sufficiency of current teaching method; (2) evolution as a learner (a novice to an expert); (3) need for objectivity; (4) tutor feedback; (5) knowledge and (6) barriers and enablers. These six factors influenced the participants' perception about the role of 3D technologies in manual therapy education with participants evidently taking two distinct/polarized positions ('no role' (techstatic) versus a 'complete role' (techsavvy)). CONCLUSION Although 3D technology may not replace face-to-face teaching, it may be used to complement the traditional approach of learning/teaching to facilitate the learning of complex skills according to the perceptions of manual therapy learners in our study. The advantage of such an approach is an area of future research.
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Affiliation(s)
- Kesava Kovanur Sampath
- Centre for Health and Social Practice, Waikato Institute of Technology, 51, Akoranga Road, Hamilton, New Zealand.
| | - Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, P.O.Box 27272, Sharjah, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS-Research Institute of Medical and Health Sciences, University of Sharjah, P.O.Box: 27272, Sharjah, United Arab Emirates
- Sustainable Engineering Asset Management Research Group, RISE-Research Institute of Sciences and Engineering, University of Sharjah, P.O.Box: 27272, Sharjah, United Arab Emirates
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Esra Yaghi
- Centre for Health and Social Practice, Waikato Institute of Technology, 51, Akoranga Road, Hamilton, New Zealand
| | - Emma Fairs
- Ara Institute of Canterbury, Christchurch, New Zealand
| | - Patrea Andersen
- Centre for Health and Social Practice, Waikato Institute of Technology, 51, Akoranga Road, Hamilton, New Zealand
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Dow, QLD, 4556, Australia
- School of Nursing, Midwifery and Social Science, CQ University, Queensland, 4702, Australia
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Webb JJ. Proof of Concept: Using ChatGPT to Teach Emergency Physicians How to Break Bad News. Cureus 2023; 15:e38755. [PMID: 37303324 PMCID: PMC10250131 DOI: 10.7759/cureus.38755] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
Background Breaking bad news is an essential skill for practicing physicians, particularly in the field of emergency medicine (EM). Patient-physician communication teaching has previously relied on standardized patient scenarios and objective structured clinical examination formats. The novel use of artificial intelligence (AI) chatbot technology, such as Chat Generative Pre-trained Transformer (ChatGPT), may provide an alternative role in graduate medical education in this area. As a proof of concept, the author demonstrates how providing detailed prompts to the AI chatbot can facilitate the design of a realistic clinical scenario, enable active roleplay, and deliver effective feedback to physician trainees. Methods ChatGPT-3.5 language model was utilized to assist in the roleplay of breaking bad news. A detailed input prompt was designed to outline rules of play and grading assessment via a standardized scale. User inputs (physician role), chatbot outputs (patient role) and ChatGPT-generated feedback were recorded. Results ChatGPT set up a realistic training scenario on breaking bad news based on the initial prompt. Active roleplay as a patient in an emergency department setting was accomplished, and clear feedback was provided to the user through the application of the Setting up, Perception, Invitation, Knowledge, Emotions with Empathy, and Strategy or Summary (SPIKES) framework for breaking bad news. Conclusion The novel use of AI chatbot technology to assist educators is abundant with potential. ChatGPT was able to design an appropriate scenario, provide a means for simulated patient-physician roleplay, and deliver real-time feedback to the physician user. Future studies are required to expand use to a targeted group of EM physician trainees and provide best practice guidelines for AI use in graduate medical education.
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Affiliation(s)
- Jeremy J Webb
- Emergency Medicine, LewisGale Medical Center, Salem, USA
- School of Medicine, Edward Via College of Osteopathic Medicine, Blacksburg, USA
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Bard JT, Chung HK, Shaia JK, Wellman LL, Elzie CA. Increased medical student understanding of dementia through virtual embodiment. GERONTOLOGY & GERIATRICS EDUCATION 2023; 44:211-222. [PMID: 35451921 DOI: 10.1080/02701960.2022.2067850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Given the growing prevalence of Alzheimer's disease (AD), we assessed the impact of virtually embodying someone with progressive AD. This pilot explored students' understanding of individuals' needs with dementia, as well as, the efficacy of virtual reality (VR) as a curricular tool. Second-year medical students (n = 150) completed a pre-survey, Embodied Labs, Inc. Beatriz Lab VR module, and a post-survey. Most students knew someone with dementia (72%), were a family member of someone with dementia (52%) or had worked with a patient (61%) with dementia. Using paired survey questions, students reported significant increases in understanding how their lives would be affected by dementia (71% vs. 94%) and the needs of a person with dementia (64% vs. 95%) after VR. They reported increased understanding of being a caregiver of someone with dementia (24% vs. 81%) and the impact it can have on the entire family (64% vs. 97%). Overall students agreed this simulation made them think about their approach to clinical skills (94%) and should be utilized more in the curriculum (76%). This pilot study indicated that this VR experience can be used to advance understanding of a person's experiences with dementia and that integrating VR into the medical curricula should be considered.
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Affiliation(s)
- Jason T Bard
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Hannah K Chung
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Jacqueline K Shaia
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Laurie L Wellman
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Carrie A Elzie
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia, USA
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Barros Una L, Brangman S, Indelicato A, Krueger A, Ludwig A, Slutzky AR, Stewart T, Germain LJ. Using second life to teach health professions students about Alzheimer's Disease: A comprehensive review. GERONTOLOGY & GERIATRICS EDUCATION 2023; 44:243-253. [PMID: 34994301 DOI: 10.1080/02701960.2021.2022660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Increased training is necessary to ensure that the next generation of health care professionals are prepared to effectively and compassionately serve patients with Alzheimer's Disease. Second Life® is a virtual world shown to provide a safe, convenient, and effective environment for teaching health-related content. To date, there has been no comprehensive review of studies using Second Life in education about Alzheimer's Disease. The authors conducted a scoping review of the literature on the use of Second Life in the education of medical, nursing, and health professions students about Alzheimer's Disease. Searches were conducted in PubMed, SCOPUS, and CINAHL. Thirty-two studies containing outcomes of the application of virtual reality and the virtual world Second Life were identified. Studies were classified using the Kirkpatrick Four-Level Training Evaluation Model. Changes in knowledge, attitudes, and confidence (Level 2), were most commonly reported, followed by positive reactions (Level 1). No studies identified system-level results and few examined changes in behavior. While results indicate positive student reactions and enhanced learning from Second Life interventions related to Alzheimer's Disease, they also highlight a need for future research examining outcomes at the higher Kirkpatrick levels.
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Affiliation(s)
- Liliana Barros Una
- Department of Public Health and Preventive Medicine, Suny Upstate Medical University, Syracuse, New York, USA
| | - Sharon Brangman
- Department of Geriatrics, Suny Upstate Medical University, Syracuse, New York, USA
| | - Alyssa Indelicato
- Department of Public Health and Preventive Medicine, Suny Upstate Medical University, Syracuse, New York, USA
| | | | | | - Amy R Slutzky
- Health Sciences Library, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Telisa Stewart
- Department of Public Health and Preventive Medicine, Suny Upstate Medical University, Syracuse, New York, USA
| | - Lauren J Germain
- Department of Public Health and Preventive Medicine, Suny Upstate Medical University, Syracuse, New York, USA
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Liu JYW, Yin YH, Kor PPK, Cheung DSK, Zhao IY, Wang S, Su JJ, Christensen M, Tyrovolas S, Leung AYM. The Effects of Immersive Virtual Reality Applications on Enhancing the Learning Outcomes of Undergraduate Health Care Students: Systematic Review With Meta-synthesis. J Med Internet Res 2023; 25:e39989. [PMID: 36877550 PMCID: PMC10028520 DOI: 10.2196/39989] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 11/09/2022] [Accepted: 01/24/2023] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND Immersive virtual reality (IVR) applications are gaining popularity in health care education. They provide an uninterrupted, scaled environment capable of simulating the full magnitude of sensory stimuli present in busy health care settings and increase students' competence and confidence by providing them with accessible and repeatable learning opportunities in a fail-safe environment. OBJECTIVE This systematic review aimed to evaluate the effects of IVR teaching on the learning outcomes and experiences of undergraduate health care students compared with other teaching methods. METHODS MEDLINE, Embase, PubMed, and Scopus were searched (last search on May 2022) for randomized controlled trials (RCTs) or quasi-experimental studies published in English between January 2000 and March 2022. The inclusion criteria were studies involving undergraduate students majoring in health care, IVR teaching, and evaluations of students' learning outcomes and experiences. The methodological validity of the studies was examined using the Joanna Briggs Institute standard critical appraisal instruments for RCTs or quasi-experimental studies. The findings were synthesized without a meta-analysis using vote counting as the synthesis metric. A binomial test with P<.05 was used to test for statistical significance using SPSS (version 28; IBM Corp). The overall quality of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation tool. RESULTS A total of 17 articles from 16 studies totaling 1787 participants conducted between 2007 and 2021 were included. The undergraduate students in the studies majored in medicine, nursing, rehabilitation, pharmacy, biomedicine, radiography, audiology, or stomatology. The IVR teaching domains included procedural training (13/16, 81%), anatomical knowledge (2/16, 12%), and orientation to the operating room setting (1/16, 6%). The quality of the 75% (12/16) of RCT studies was poor, with unclear descriptions of randomization, allocation concealment, and outcome assessor blinding procedures. The overall risk of bias was relatively low in the 25% (4/16) of quasi-experimental studies. A vote count showed that 60% (9/15; 95% CI 16.3%-67.7%; P=.61) of the studies identified similar learning outcomes between IVR teaching and other teaching approaches regardless of teaching domains. The vote count showed that 62% (8/13) of the studies favored using IVR as a teaching medium. The results of the binomial test (95% CI 34.9%-90%; P=.59) did not show a statistically significant difference. Low-level evidence was identified based on the Grading of Recommendations Assessment, Development, and Evaluation tool. CONCLUSIONS This review found that undergraduate students had positive learning outcomes and experiences after engaging with IVR teaching, although the effects may be similar to those of other forms of virtual reality or conventional teaching methods. Given the identification of risk of bias and low level of the overall evidence, more studies with a larger sample size and robust study design are required to evaluate the effects of IVR teaching. TRIAL REGISTRATION International prospective register of systematic reviews (PROSPERO) CRD42022313706; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=313706.
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Affiliation(s)
- Justina Yat Wa Liu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Yue-Heng Yin
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Patrick Pui Kin Kor
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | | | - Ivy Yan Zhao
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Shanshan Wang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Martin Christensen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Stefanos Tyrovolas
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Angela Y M Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
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Learning about Victims of Holocaust in Virtual Reality: The Main, Mediating and Moderating Effects of Technology, Instructional Method, Flow, Presence, and Prior Knowledge. MULTIMODAL TECHNOLOGIES AND INTERACTION 2023. [DOI: 10.3390/mti7030028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
The goal of the current study was to investigate the effects of a virtual reality (VR) simulation of Anne Frank’s hiding place on learning. In a 2 × 2 experiment, 132 middle school students learned about the living conditions of Anne Frank, a girl of Jewish heritage during the Second World War, through desktop VR (DVR) and head-mounted display VR (HMD-VR) (media conditions). Approximately half of each group engaged in an explorative vs. an expository learning approach (method condition). The exposition group received instructions on how to explore the hiding place stepwise, whereas the exploration group experienced it autonomously. Next to the main effects of media and methods, the mediating effects of the learning process variables of presence and flow and the moderating effects of contextual variables (e.g., prior technical knowledge) have been analyzed. The results revealed that the HMD-VR led to significantly improved evaluation, and—even if not statistically significant—perspective-taking in Anne, but less knowledge gain compared to DVR. Further results showed that adding instructions and segmentation within the exposition group led to significantly increased knowledge gain compared to the exploration group. For perspective-taking and evaluation, no differences were detected. A significant interaction between media and methods was not found. No moderating effects by contextual variables but mediating effects were observed: For example, the feeling of presence within VR can fully explain the relationships between media and learning. These results support the view that learning processes are crucial for learning in VR and that studies neglecting these learning processes may be confounded. Hence, the results pointed out that media comparison studies are limited because they do not consider the complex interaction structures of media, instructional methods, learning processes, and contextual variables.
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Ahuja AS, Polascik BW, Doddapaneni D, Byrnes ES, Sridhar J. The Digital Metaverse: Applications in Artificial Intelligence, Medical Education, and Integrative Health. Integr Med Res 2023; 12:100917. [PMID: 36691642 PMCID: PMC9860100 DOI: 10.1016/j.imr.2022.100917] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/06/2022] [Accepted: 11/16/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Abhimanyu S. Ahuja
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States of America
| | - Bryce W. Polascik
- Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Divyesh Doddapaneni
- Department of Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Eamonn S. Byrnes
- Department of Internal Medicine, Orlando Regional Medical Center, Orlando, Florida, United States of America
| | - Jayanth Sridhar
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, Florida, United States of America,Corresponding author at: Jayanth Sridhar, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, 900 NW 17th Street, Miami, FL, 33136.
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Ntakakis G, Plomariti C, Frantzidis C, Antoniou PE, Bamidis PD, Tsoulfas G. Exploring the use of virtual reality in surgical education. World J Transplant 2023; 13:36-43. [PMID: 36908307 PMCID: PMC9993190 DOI: 10.5500/wjt.v13.i2.36] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/14/2022] [Accepted: 01/03/2023] [Indexed: 02/16/2023] Open
Abstract
Virtual reality (VR) technologies have rapidly developed in the past few years. The most common application of the technology, apart from gaming, is for educational purposes. In the field of healthcare, VR technologies have been applied in several areas. Among them is surgical education. With the use of VR, surgical pathways along with the training of surgical skills can be explored safely, in a cost-effective manner. The aim of this mini-review was to explore the use of VR in surgical education and in the 3D reconstruction of internal organs and viable surgical pathways. Finally, based on the outcomes of the included studies, an ecosystem for the implementation of surgical training was proposed.
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Affiliation(s)
- Georgios Ntakakis
- Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Christina Plomariti
- Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Christos Frantzidis
- School of Computer Science, University of Lincoln, Lincoln LN6 7TS, United Kingdom
| | - Panagiotis E Antoniou
- Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Panagiotis D Bamidis
- Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Georgios Tsoulfas
- Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
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41
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Giordano NA, Febres-Cordero S, Baker H, Pfeiffer KM, Walsh LM, Gish A, Axson SA. Opioid-involved overdose trainings delivered using remote learning modalities. Nurs Open 2023; 10:4132-4136. [PMID: 36681653 PMCID: PMC10170917 DOI: 10.1002/nop2.1615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/27/2022] [Accepted: 01/10/2023] [Indexed: 01/23/2023] Open
Abstract
AIM This education-focused study examined changes in nursing students' knowledge and attitudes towards responding to opioid-involved overdoses following participation in trainings delivered using remote learning modalities. DESIGN This pre-post study examined learning outcomes among 17 nursing students. METHODS Participants completed the Opioid Overdose Attitude Scale and Opioid Overdose Knowledge Scale to assess attitudes and knowledge, respectively. Trainings were delivered to two separate groups, one via virtual reality immersive video and another over video conferencing. RESULTS Attitude scores increased by an average of 12.2 points and knowledge scores increased by 1.65 points. Within the virtual reality group, attitude scores increased by an average of 10 points, while no significant changes were observed in knowledge scores. The video conferencing group improved in both attitude and knowledge scores, by an average of 16.2 points and 2.1 points, respectively. CONCLUSIONS These hypothesis generating results illustrate the utility of remote learning approaches to deliver trainings, while maintaining social distance during the ongoing COVID-19 pandemic.
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Affiliation(s)
- Nicholas A Giordano
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Sarah Febres-Cordero
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Helen Baker
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Katherine M Pfeiffer
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Lisa Marie Walsh
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Andy Gish
- Independent Harm Reduction Expert, Atlanta, Georgia, USA
| | - Sydney A Axson
- National Clinician Scholars Program, Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
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Koyama Y, Sugahara K, Koyachi M, Tachizawa K, Iwasaki A, Wakita I, Nishiyama A, Matsunaga S, Katakura A. Mixed reality for extraction of maxillary mesiodens. Maxillofac Plast Reconstr Surg 2023; 45:1. [PMID: 36602618 PMCID: PMC9816364 DOI: 10.1186/s40902-022-00370-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 12/25/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Mesiodentes are the most common supernumerary teeth. The cause is not fully understood, although proliferations of genetic factors and the dental lamina have been implicated. Mesiodentes can cause delayed or ectopic eruption of permanent incisors, which can further alter occlusion and appearance. Careful attention should be paid to the position and direction of the mesiodentes because of possible damage to adjacent roots in the permanent dentition period, errant extraction in the deciduous and mixed dentition periods, and damage to the permanent tooth embryo. To avoid these complications, we applied mixed reality (MR) technology using the HoloLens® (Microsoft, California). In this study, we report on three cases of mesiodentes extraction under general anesthesia using MR technology. RESULTS The patients ranged in age from 6 to 11 years, all three were boys, and the direction of eruption was inverted in all cases. The extraction approach was palatal in two cases and labial in one case. The average operative time was 32 min, and bleeding was minimal in all cases. No intraoperative or postoperative complications occurred. An image was shared preoperatively with all the surgeons using an actual situation model. Three surgeons used Microsoft HoloLens® during surgery, shared MR, and operated while superimposing the application image in the surgical field. CONCLUSIONS The procedure was performed safely; further development of MR surgery support systems in the future is suggested.
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Affiliation(s)
- Yu Koyama
- grid.265070.60000 0001 1092 3624Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, 2-9-18 Kanda Misaki-Cho, Chiyoda-Ku, Tokyo, Japan
| | - Keisuke Sugahara
- grid.265070.60000 0001 1092 3624Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, 2-9-18 Kanda Misaki-Cho, Chiyoda-Ku, Tokyo, Japan ,grid.265070.60000 0001 1092 3624Oral Health Science Center, Tokyo Dental College, 2-9-18 Kanda Misaki-Cho, Chiyoda-Ku, Tokyo, Japan
| | - Masahide Koyachi
- grid.265070.60000 0001 1092 3624Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, 2-9-18 Kanda Misaki-Cho, Chiyoda-Ku, Tokyo, Japan
| | - Kotaro Tachizawa
- grid.265070.60000 0001 1092 3624Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, 2-9-18 Kanda Misaki-Cho, Chiyoda-Ku, Tokyo, Japan
| | - Akira Iwasaki
- grid.265070.60000 0001 1092 3624Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, 2-9-18 Kanda Misaki-Cho, Chiyoda-Ku, Tokyo, Japan
| | - Ichiro Wakita
- grid.265070.60000 0001 1092 3624Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, 2-9-18 Kanda Misaki-Cho, Chiyoda-Ku, Tokyo, Japan
| | - Akihiro Nishiyama
- grid.265070.60000 0001 1092 3624Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, 2-9-18 Kanda Misaki-Cho, Chiyoda-Ku, Tokyo, Japan
| | - Satoru Matsunaga
- grid.265070.60000 0001 1092 3624Department of Anatomy, Tokyo Dental College, 2-9-18 Kanda Misaki-Cho, Chiyoda-Ku, Tokyo, Japan
| | - Akira Katakura
- grid.265070.60000 0001 1092 3624Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, 2-9-18 Kanda Misaki-Cho, Chiyoda-Ku, Tokyo, Japan ,grid.265070.60000 0001 1092 3624Oral Health Science Center, Tokyo Dental College, 2-9-18 Kanda Misaki-Cho, Chiyoda-Ku, Tokyo, Japan
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Gan W, Mok TN, Chen J, She G, Zha Z, Wang H, Li H, Li J, Zheng X. Researching the application of virtual reality in medical education: one-year follow-up of a randomized trial. BMC MEDICAL EDUCATION 2023; 23:3. [PMID: 36597093 PMCID: PMC9808681 DOI: 10.1186/s12909-022-03992-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 12/27/2022] [Indexed: 05/23/2023]
Abstract
BACKGROUND Compared with traditional tendon repair teaching methods, using a virtual reality (VR) simulator to teach tendon suturing can significantly improve medical students' exercise time, operation flow and operation knowledge. At present, the purpose of this study is to explore the long-term influence of VR simulator teaching on the practice performance of medical students. METHOD This is a one-year long-term follow-up study of a randomized controlled study. A total of 117 participants who completed the initial study were invited to participate in the follow-up study. Participants in the VR group and the control group were required to complete a questionnaire developed by the authors and the teachers in the teaching and research department and to provide their surgical internship scores and Objective Structure Clinical Examination(OSCE) graduation scores. RESULTS Of the 117 invitees, 108 completed the follow-up. The answers to the questions about career choice and study habits were more positive in the VR group than in the control group (p < 0.05). The total score for clinical practice in the VR group was better than that in the control group, and the difference was statistically significant (p < 0.05). In the OSCE examination, the scores for physical examination, suturing and knotting and image reading were higher in the VR group than in the control group, and the difference was statistically significant (p < 0.05). CONCLUSION The results of the one-year long-term follow-up indicated that compared with medical students experiencing the traditional teaching mode, those experiencing the VR teaching mode had more determined career pursuit and active willingness to learn, better evaluations from teachers in the process of surgical clinical practice, and better scores in physical examination, suturing and knotting and image reading in the OSCE examination. In the study of nonlinear dynamics to cultivate a good learning model for medical students, the VR teaching model is expected to become an effective and stable initial sensitive element. TRIAL REGISTRATION Chinese Clinical Trial Registry(25/05/2021, ChiCTR2100046648); http://www.chictr.org.cn/hvshowproject.aspx?id=90180 .
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Affiliation(s)
- Wenyi Gan
- Institute of Orthopedics Diseases and Center for Joint Surgery and Sports Medicine The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Tsz-Ngai Mok
- Institute of Orthopedics Diseases and Center for Joint Surgery and Sports Medicine The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Junyuan Chen
- Institute of Orthopedics Diseases and Center for Joint Surgery and Sports Medicine The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Guorong She
- Institute of Orthopedics Diseases and Center for Joint Surgery and Sports Medicine The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zhengang Zha
- Institute of Orthopedics Diseases and Center for Joint Surgery and Sports Medicine The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Huajun Wang
- Institute of Orthopedics Diseases and Center for Joint Surgery and Sports Medicine The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Hua Li
- Department of orthopedics, General Hospital of Chinese PLA, No 28 Fuxing Road, 100853, Beijing, China
| | - Jieruo Li
- Institute of Orthopedics Diseases and Center for Joint Surgery and Sports Medicine The First Affiliated Hospital of Jinan University, Guangzhou, China.
| | - Xiaofei Zheng
- Institute of Orthopedics Diseases and Center for Joint Surgery and Sports Medicine The First Affiliated Hospital of Jinan University, Guangzhou, China.
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Wilding C, Young K, Cummins C, Bowler C, Dean T, Lakhani A, Blackberry I. Virtual reality to foster empathy in disability workers: A feasibility study during COVID-19. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:132-142. [PMID: 36250222 PMCID: PMC9874843 DOI: 10.1111/jar.13042] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 09/14/2022] [Accepted: 09/27/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Empathy is a critical skill required by disability workers. Virtual reality may increase access to staff training to foster empathy. METHOD A mixed methods feasibility study investigated a custom-built virtual reality program, IMercyVE, which aimed to immerse a disability worker in a first-person perspective of having intellectual disability. Data were collected through online surveys (n = 9) completed before and after use of IMercyVE, and by videoconference focus groups (n = 6). RESULTS Qualitative findings included that IMercyVE delivered a novel experience for participants and a distinctive mode of learning that assisted participants to deepen their levels of empathy. Descriptive analyses of the surveys indicated that participants' empathy increased after engaging with IMercyVE. CONCLUSIONS IMercyVE has the potential to be offered as a remotely delivered and flexible staff training modality suitable for building empathy. Further research with a larger sample is warranted.
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Affiliation(s)
- Clare Wilding
- John Richards Centre for Rural Ageing ResearchLa Trobe Rural Health School, La Trobe UniversityWodongaVictoriaAustralia
| | - Kimberleigh Young
- John Richards Centre for Rural Ageing ResearchLa Trobe Rural Health School, La Trobe UniversityWodongaVictoriaAustralia
| | | | - Craig Bowler
- Valley General HospitalBrisbaneQueenslandAustralia
| | - Trent Dean
- Mercy ConnectAlburyNew South WalesAustralia
| | - Ali Lakhani
- Public HealthLa Trobe UniversityMelbourneVictoriaAustralia
| | - Irene Blackberry
- John Richards Centre for Rural Ageing ResearchLa Trobe Rural Health School, La Trobe UniversityWodongaVictoriaAustralia
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Virtual and Augmented Reality versus Traditional Methods for Teaching Physiotherapy: A Systematic Review. Eur J Investig Health Psychol Educ 2022; 12:1780-1792. [PMID: 36547026 PMCID: PMC9778016 DOI: 10.3390/ejihpe12120125] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022] Open
Abstract
The use of virtual worlds in health-related education is increasingly popular, but an overview of their use in physiotherapy education is still needed. The aim of this review was to analyse the use of virtual and augmented reality (VR/AR) compared to traditional methods for teaching physiotherapy. A systematic review was performed up to October 2022 in PubMed, Web of Science, Scopus, CINAHL, and PsycInfo. The quality appraisal and risk of bias were assessed by the Joana Briggs Institute checklist and the Cochrane Collaboration's RoB Tool 2.0, respectively. A total of seven randomised and non-randomised controlled studies were included, involving 737 students. VR/AR-based teaching approaches included simulation and virtual worlds, and were conducted through immersive head-mounted displays, AR-based applications, and 3D visualisations. Three studies were focused on teaching anatomy content, two on clinical decision making skills, and the rest were focused on pathology, physiotherapy tasks or exercise performance, and movement analysis of lower limbs. Inconclusive results were found in terms of learning satisfaction and academic performance, showing VR/AR-based teaching models to be equally effective as traditional methods for teaching physiotherapy. We encourage researchers and teachers to include games in their VR/AR-based teaching approaches to enhance interaction and active learning in physiotherapy education.
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Seinfeld S, Hasler BS, Banakou D, Levy J. Editorial: Virtual reality and empathy. Front Psychol 2022; 13:1089006. [DOI: 10.3389/fpsyg.2022.1089006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/10/2022] [Indexed: 11/23/2022] Open
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Parra Vargas E, García Delgado A, Torres SC, Carrasco-Ribelles LA, Marín-Morales J, Alcañiz Raya M. Virtual reality stimulation and organizational neuroscience for the assessment of empathy. Front Psychol 2022; 13:993162. [PMID: 36420385 PMCID: PMC9677823 DOI: 10.3389/fpsyg.2022.993162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/05/2022] [Indexed: 11/09/2022] Open
Abstract
This study aimed to evaluate the viability of a new procedure based on machine learning (ML), virtual reality (VR), and implicit measures to discriminate empathy. Specifically, eye-tracking and decision-making patterns were used to classify individuals according to their level in each of the empathy dimensions, while they were immersed in virtual environments that represented social workplace situations. The virtual environments were designed using an evidence-centered design approach. Interaction and gaze patterns were recorded for 82 participants, who were classified as having high or low empathy on each of the following empathy dimensions: perspective-taking, emotional understanding, empathetic stress, and empathetic joy. The dimensions were assessed using the Cognitive and Affective Empathy Test. An ML-based model that combined behavioral outputs and eye-gaze patterns was developed to predict the empathy dimension level of the participants (high or low). The analysis indicated that the different dimensions could be differentiated by eye-gaze patterns and behaviors during immersive VR. The eye-tracking measures contributed more significantly to this differentiation than did the behavioral metrics. In summary, this study illustrates the potential of a novel VR organizational environment coupled with ML to discriminate the empathy dimensions. However, the results should be interpreted with caution, as the small sample does not allow general conclusions to be drawn. Further studies with a larger sample are required to support the results obtained in this study.
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Affiliation(s)
- Elena Parra Vargas
- Institute for Research and Innovation in Bioengineering, Polytechnic University of Valencia, Valencia, Spain
- *Correspondence: Elena Parra Vargas,
| | - Aitana García Delgado
- Institute for Research and Innovation in Bioengineering, Polytechnic University of Valencia, Valencia, Spain
| | - Sergio C. Torres
- Institute for Research and Innovation in Bioengineering, Polytechnic University of Valencia, Valencia, Spain
| | - Lucía A. Carrasco-Ribelles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Cornellà de Llobregat, Spain
| | - Javier Marín-Morales
- Institute for Research and Innovation in Bioengineering, Polytechnic University of Valencia, Valencia, Spain
| | - Mariano Alcañiz Raya
- Institute for Research and Innovation in Bioengineering, Polytechnic University of Valencia, Valencia, Spain
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48
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Hu S, Lai BWP. Increasing empathy for children in dental students using virtual reality. Int J Paediatr Dent 2022; 32:793-800. [PMID: 35146818 DOI: 10.1111/ipd.12957] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/02/2022] [Accepted: 02/02/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Virtual reality (VR) can be used to simulate the viewpoint of a child to allow dental students to experience what a child experiences during a dental visit. AIM The aim of this study was to evaluate the effect of VR simulation on the empathy and comfort managing children among dental students. DESIGN Sixty dental students experienced a VR scenario created for the study. Empathy levels were examined using the Jefferson Scale of Empathy (JSE). A self-administered questionnaire was used to collect information on self-perceived ability, comfort and impact of the intervention. RESULTS There was a significant (p = .004) increase (indicating greater empathy) in JSE scores between pre-intervention (112.35 ± 9.34) and post-intervention (117.64 ± 10.03), which returned to baseline 3 months later (112.72 ± 10.36). Dental students perceived themselves to be more confident at communicating (6.45 ± 1.64 vs. 5.75 ± 1.71, p = .011) and interacting (6.63 ± 1.44 vs. 6.00 ± 1.78, p = .046) with children after the intervention. All (100%) felt that the VR scenarios helped them better empathize with children. Only 30% revisited the scenario after the intervention, and they were significantly more likely (p < .001) to find it helpful for actual clinical sessions. CONCLUSION Virtual reality could be used to improve empathy, self-perceived comfort and ability at managing children in dental students. Yet, they should be encouraged to revise using it to maintain this effect.
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Affiliation(s)
- Shijia Hu
- Faculty of Dentistry, National University of Singapore, Singapore City, Singapore
| | - Bien Wen Pui Lai
- Restorative Department, National Dental Centre Singapore, Singapore City, Singapore
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Lin IH, Wang CY, Lin YN, Chen HC, Lin LF. Simulation-based holistic education in physiotherapy interns to increase empathy toward older adults and individuals with disabilities. BMC Geriatr 2022; 22:795. [PMID: 36224529 PMCID: PMC9555068 DOI: 10.1186/s12877-022-03500-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 10/05/2022] [Indexed: 11/30/2022] Open
Abstract
Background The proportion of older adults and individuals with disabilities in the general population increases each year. Thus, clinical clerkships designed for physiotherapy interns should provide more than simply knowledge and skills. For such interns to be able to handle the requirements of their future jobs, clerkships must enable them to develop empathy and positive attitudes toward patients. This study investigated the effect of simulation-based, holistic health-care education on physiotherapy interns’ empathy, attitudes, and knowledge. Methods A parallel-group design. Thirty physiotherapy interns from a medical institution were enrolled as participants, with experimental and control groups each comprising 15 participants. Both groups received standard clinical training. However, the experimental group received an additional 3.5 h of simulation-based holistic health-care education. The Jefferson Scale of Empathy, Kogan’s Attitudes Toward Old People Scale, the Attitudes Towards the Elderly Scale, the Knowledge About Aging Scale, Knowledge of the Situation of Older People Scale, Perceptions of Working with Older People Scale, and Care Willingness Scale were used in a pretest and posttest. Results After the intervention period, we observed substantial between-group differences of 6.4 points on the Jefferson Scale of Empathy (p = 0.001), 7.7 points on Kogan’s Attitudes Toward Old People Scale (p = 0.002), 3.5 points on the Attitudes Toward the Elderly Scale (p = 0.002), 2.5 points on Knowledge About Aging (p = 0.055), 4.5 points on the Knowledge of the Situation of Older People Scale (p < 0.001), and 2.1 points on Perceptions of Working with Older People Scale (p = 0.046). Conclusion Simulation-based, holistic health-care education can significantly improve the empathy, knowledge, and attitudes of physiotherapy interns.
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Affiliation(s)
- I-Hsien Lin
- Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chien-Yung Wang
- Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yen-Nung Lin
- Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
| | - Hung-Chou Chen
- Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan.,Department of Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan
| | - Li-Fong Lin
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan. .,School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan. .,Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan. .,Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan.
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50
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Hsin LJ, Chao YP, Chuang HH, Kuo TBJ, Yang CCH, Huang CG, Kang CJ, Lin WN, Fang TJ, Li HY, Lee LA. Mild simulator sickness can alter heart rate variability, mental workload, and learning outcomes in a 360° virtual reality application for medical education: a post hoc analysis of a randomized controlled trial. VIRTUAL REALITY 2022; 27:1-17. [PMID: 36118174 PMCID: PMC9470506 DOI: 10.1007/s10055-022-00688-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 04/28/2022] [Indexed: 06/02/2023]
Abstract
Virtual reality (VR) applications could be beneficial for education, training, and treatment. However, VR may induce symptoms of simulator sickness (SS) such as difficulty focusing, difficulty concentrating, or dizziness that could impair autonomic nervous system function, affect mental workload, and worsen interventional outcomes. In the original randomized controlled trial, which explored the effectiveness of using a 360° VR video versus a two-dimensional VR video to learn history taking and physical examination skills, only the former group participants had SS. Therefore, 28 undergraduate medical students who participated in a 360° VR learning module were included in this post hoc study using a repeated measures design. Data of the Simulator Sickness Questionnaire (SSQ), heart rate variability (HRV) analysis, Task Load Index, and Mini-Clinical Evaluation Exercise were retrospectively reviewed and statistically analyzed. Ten (36%) participants had mild SS (total score > 0 and ≤ 20), and 18 (64%) had no SS symptom. Total SSQ score was positively related to the very low frequency (VLF) band power, physical demand subscale, and frustration subscale, and inversely related to physical examination score. Using multilevel modeling, the VLF power mediated the relationship between total SSQ score and physical examination score. Furthermore, frustration subscale moderated the mediating effects of the VLF power. Our results highlight the importance of documenting SS to evaluate a 360° VR training program. Furthermore, the combination of HRV analysis with mental workload measurement and outcome assessments provided the important clinical value in evaluating the effects of SS in VR applications in medical education.
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Affiliation(s)
- Li-Jen Hsin
- Department of Otorhinolaryngology-Head and Neck Surgery, Sleep Center, Linkou Medical Center, Linkou Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street, Gueishan District, Taoyuan City, 33305 Taiwan, Republic of China
- Faculty of Medicine, Graduate Institute of Clinical Medicine Sciences, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Yi-Ping Chao
- Department of Computer Science and Information Engineering, Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan, 33302 Taiwan
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, 33305 Taiwan
| | - Hai-Hua Chuang
- Faculty of Medicine, Graduate Institute of Clinical Medicine Sciences, Chang Gung University, Taoyuan, 33302 Taiwan
- Department of Family Medicine, Taipei Branch and Linkou Main Branch, Linkou Medical Center, Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street, Gueishan District, Taoyuan, 33305 Taiwan, Republic of China
- Department of Industrial Engineering and Management, National Taipei University of Technology, Taipei, 10608 Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, 300044 Taiwan
| | - Terry B. J. Kuo
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 11221 Taiwan
| | - Cheryl C. H. Yang
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 11221 Taiwan
| | - Chung-Guei Huang
- Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, 33305 Taiwan
- Department of Medical Biotechnology and Laboratory Science, Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Chung-Jan Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Sleep Center, Linkou Medical Center, Linkou Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street, Gueishan District, Taoyuan City, 33305 Taiwan, Republic of China
- Faculty of Medicine, Graduate Institute of Clinical Medicine Sciences, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Wan-Ni Lin
- Department of Otorhinolaryngology-Head and Neck Surgery, Sleep Center, Linkou Medical Center, Linkou Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street, Gueishan District, Taoyuan City, 33305 Taiwan, Republic of China
- Faculty of Medicine, Graduate Institute of Clinical Medicine Sciences, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Tuan-Jen Fang
- Department of Otorhinolaryngology-Head and Neck Surgery, Sleep Center, Linkou Medical Center, Linkou Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street, Gueishan District, Taoyuan City, 33305 Taiwan, Republic of China
- Faculty of Medicine, Graduate Institute of Clinical Medicine Sciences, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Hsueh-Yu Li
- Department of Otorhinolaryngology-Head and Neck Surgery, Sleep Center, Linkou Medical Center, Linkou Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street, Gueishan District, Taoyuan City, 33305 Taiwan, Republic of China
- Faculty of Medicine, Graduate Institute of Clinical Medicine Sciences, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Li-Ang Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Sleep Center, Linkou Medical Center, Linkou Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street, Gueishan District, Taoyuan City, 33305 Taiwan, Republic of China
- Faculty of Medicine, Graduate Institute of Clinical Medicine Sciences, Chang Gung University, Taoyuan, 33302 Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 11221 Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, 300044 Taiwan
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